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Average Cost for People with Hospital ER Visit, MEPS Editor's Pick

Average expenses for people who had one or more visits to the Emergency Room (ER) were $1533 in 2014, up 7.7% from 2013 according to the Medical Expenditure Panel Survey (MEPS). Median, or typical, cost was $749. For people ages 45 to 64, the cost was substantially higher on average ($2176, up 18%). Uninsured people under age 65 averaged $1251 in expenses ($585 median), of which they paid more than 1/3 out of pocket. While average cost for those age 65 and up was generally $1300-1400, Medicare recipients paid only 3 to 6% out of pocket. Median charges for children under age 18 were $449 to $544. In a separate report (not shown), the average expenditure PER Emergency Room visit for 2016 was reported at $1004, compared to $265 for a physician office visit. Many ER users end up having more than one trip to the Emergency department, so the expenses can add up in a year. The federal government has not prepared a detailed report for the 2016 data, yet. It may have discontinued detailed explanations, in favor of the online interactive tool – which we think would be very unfortunate.

Emergency Medical Services (MedlinePlus)

Emergency Medical Services page at MedlinePlus includes multiple reports by the American College of Emergency Physicians, on topics such as Emergency Room (ER) costs, tips for seniors, children and when to use the emergency department

Emergency Room or Urgent Care?

Should you go to the Emergency Room (ER), or to an urgent care center? Useful overview, by a private for-profit company solvhealth.com

Pediatric Emergency Care Guidelines (2009)

The American Academy of Pediatrics published guidelines for medical and nursing leadership, equipment, medications and protocols for treating children in the Emergency Department. Collaborative effort with other professional associations, 2009, and reaffirmed February 2016. Free full text

Trauma Programs: Verified Trauma Centers (ACS)

Level I, II and III Trauma Centers are listed here, by state (and other international locations), at the American College of Surgeons’ website. Trauma Center designation is a voluntary process that hospitals may choose to pursue for Adult and/or Pediatric care. Level I is the highest level of five levels. A description of what’s expected to be available at each level can be found at amtrauma.org.

Truth about ER Visits: 2016 Data from CDC

CDC’s 2016 National Hospital Ambulatory Medical Care Survey reveals the median waiting time to see a physician or other provider in the Emergency Dept. was 17 minutes (see Table 4), a minute shorter than the previous year. Most patients (56%) spent between one and four hours in the Emergency Room (ER). About 58% arrived outside of the M-F 8a to 5p hours. More than half (57%) of ER patients were triaged as semiurgent or urgent when they arrived. (However, when billed at discharge or admitted to the hospital, the overwhelming majority of ER visits are likely to be billed as at least a moderate to high severity. Data not shown in this report.) Percent admitted or transferred to another hospital (including observation stays): 13.5%. Main reasons for an ER visit: stomach and abdominal pain, cramps or spasms; chest pain and fever. Cough and headaches also were common. Of the 45 million injury-related (or poisoning or adverse effects) visits, 23% were for falls – 2.8 times the rate of motor vehicle traffic-related injuries seen in Emergency Rooms. 2017 and 2018 ER information not yet available. Click on NHAMCS Emergency Department Summary Tables

Urgent Care – When Should I Go?

Example of a health system’s suggestion for using a clinic Urgent Care setting vs. a hospital Emergency Room. Example is from Scripps in California

Other Helpful Listings

Accredited Healthcare Facilities – Joint Commission Accreditation (all states) Editor's Pick

The Joint Commission (formerly JCAHO – Joint Commission on Accreditation of Healthcare Organizations) accredits hospitals and other healthcare organizations. Quality Check provides accreditation and comparison information for hospitals, behavioral health care, home health/hospice, laboratories, some nursing homes (called nursing care centers) & assisted living centers, and other health care services. A few actual scores for acute care hospitals  and behavioral health (mental health) programs may be available for 2018.  For nursing homes, consumers are advised also to check state inspection reports . We recently discovered a 1-star Florida nursing home (the lowest possible rating in the state) had been accredited by the Joint Commission. Consumers are always advised to check multiple sources and ratings when researching quality of care. Conflicts in scores may suggest quality is not consistent.

Air Ambulance – Air Medical Base Locations by State

Atlas and Database of Air Medical Services (ADAMS) lists air medical service providers, types and number of aircraft, geographic coverage. Supported by the Association of Air Medical Services (AAMS). No utilization data. Updated 2018

All-Terrain Vehicle (ATV) Injuries, 2017 (pdf)

The Consumer Product Safety Commission has issued its annual report of injuries and deaths from ATVs. Injuries brought 93,800 people to the ER in 2017, with 26% of them (24,000 kids) under age 16. Injuries have declined by more than 1/3 since 2007. In 2016 there were an estimated 531 ATV deaths, but reporting is preliminary and still ongoing. Report released February 2019

Arkansas Hospital Volumes, Prices, Quality Ratings – by name of hospital

Find average charges (a proxy for average costs) for 40 common hospitalizations at specific AR hospitals by Clicking on INPATIENT PRICING after you’ve selected your hospital. Price List varies by hospital, but may include maternity and childbirth, stroke, chest pain, stomach disorders, back pain, nutritional problems (diabetes), blood infection (septicemia), rehabilitation, heart attack, cardiac cath, drug coated stent, congestive heart failure, kidney failure, urinary infection, COPD, pneumonia, total hip or knee replacement surgery, hysterectomy, psychiatric care, ventilator support and more. Note: Definitions conflict for whether data such as Volumes are Medicare-only, or reflect all patients. To find quality scores on emergency department, heart attack, heart failure, pneumonia, COPD, stroke, delivery or surgical infections, and patient opinions, click on QUALITY at each hospital’s page. Hospital Consumer Assist is provided by the Arkansas Hospital Association. Prices from 2016; Quality and Patient Satisfaction scores reflect 2017 ratings

Emergency Dept. Report – Florida 2015 data (pdf)

Summary report shows average cost (charges) for a hospital ER visit based on acuity. Low acuity Pediatric visit was about $900 in 2015; high acuity pediatric ER visit was about $2800. A For adult women, low acuity mean charge was $1785; High acuity average 2015 charge for men was $6673. Common symptoms (e.g.$2012 for upper respiratory infection visit; $9167 adults for abdominal pain visit to the ER; $3791 for a sprain; $5906 for adult headache including migraine, adult urinary tract infection averaged $6258 and more.) Average cost increased with age. See Tables 4 and 5 for average prices for an emergency visit and Insurance status or Self-Pay charges. 28 pages, published by FL Agency for Health Care Admin. Nov. 2016. No updates as of early 2019.

Florida ER Visit Charges, 2017 (interactive)

Find the average cost of an emergency room (ER / ED) visit at each Florida hospital in 2017. State average ER visit cost (charge) was $6136 (about $55 Billion for nearly 9 million ED visits). North Florida Regional Medical Center in Gainesville had the highest average charge in FL at a whopping $15,136 per ER visit in 2017. Only 1 hospital (Regional General Hospital Williston) had an average charge of $1000 or less. Volume of patients shown here. The highest volume Emergency Department was Lakeland Regional Medical Center, with nearly 170,000 visits. Its average price was $6457.  Complexity and seriousness of the visit vary from hospital to hospital. Easy to use tool, but not diagnosis-specific. From FloridaHealthFinder.gov.  Check our listing for Hospital Compare to see their most recent star ratings and performance on emergency care.

Georgia Health Insurance Plan Ratings and Comparisons 2018

Scroll to the bottom to find External Quality Review Organization (EQRO) which lets consumers read about performance of health plans in GA.  Very difficult to navigate. Compare quality ratings and member satisfaction scores for Medicaid, Amerigroup Community Care, Peach State Health Plan, WellCare of Georgia and The Georgia Families Amerigroup 360. Covers access to care, dental visits, opioids at high dosage, ER visits, diabetes care, prenatal care, 7-day followup after mental health admission, member opinions and more using 2016-2017 scores. Other reports are at this website that may have more information. Released in 2018 by Georgia Dept. of Community Health at dch.georgia.gov

How Much Does an Office Visit cost compared to an ER visit?

An average physician office visit in 2008 cost $199, compared to $922 for an Emergency Room visit (median was $89 for doctor’s visit, vs. $422 for ER). Top 5 conditions shown for each ambulatory care visit type. Consumers should expect considerably higher prices since 2008; $922 in 2008 is about $1244 in 2019 using medical inflation factors. However, this report informs consumers about the drastic difference between price of care in a doctor’s office vs. Emergency Dept. MEPS data published in Statistical Brief #318, March 2011

Louisiana Hospital Ratings and Prices – LA Hospital Inform

Find range of charges (low price and high price) for Medicare patients at Louisiana hospitals, both inpatient and outpatient. Hospital-specific inpatient charges do not include childbirth or C-section, since it’s Medicare only. Find hip or knee surgery prices, gall bladder removal, psychiatric admission, rehab, heart problems, stent, stomach problems, stroke, GI hemorrhage, kidney failure, COPD, pneumonia, diabetes, bowel surgery, more; outpatient Medicare prices include ER visits, heart tests such as cardiac cath, EKG, heart imaging, valve repair; CAT scan or CT angiography, GI endoscopy, more. Quality scores and volumes (which cover all patients), are similar to those at HospitalCompare, but may be less current (2017). LA Hospital Inform is sponsored by the Louisiana Hospital Association; Price ranges from 2017 (outpatient and inpatient)

Massachusetts Hospital Staffing Plans 2019

Massachusetts Hospital Association website presents each hospital’s unit-by-unit staffing plans budgeted for 2019, by shift, and actual staffing for fiscal year 2018 (and prior years). First in the country to voluntarily post nurse-to-patient staffing ratios. May be difficult for consumers to interpret to compare MA hospital performance, especially with all the different types of inpatient units. However, the Emergency Department information also includes specialties such as Chest Pain Center and Stroke Center, and average daily number of ER visits. Massachusetts PatientCareLink; click on Staffing Plans

Michigan – Compare Hospitals, Physician Groups, Nursing Homes in SE Mich.

The Greater Detroit Area Health Council provides a 7-county health care performance report at MyCareCompare.org. Compare MI hospitals (side-by-side) for childbirth, COPD, emergency department (ER), heart attack, heart failure, cardiac surgery, hip or knee replacements, imaging, infections, patient safety, pneumonia, surgical infection prevention and overall patient satisfaction. See mortality ratings (survival rate) for some conditions. Same info as listed at the federal HospitalCompare site, except mycarecompare might not be updated as often, so check the federal site. The advantage of mycarecompare is that consumers can see Above Average and Below Average comparisons very quickly, for the selected hospitals they want to look at, and all health conditions at once. Very easy to use. Physician group and nursing home results are at this site. GDAHC hospitals are in Detroit, Ann Arbor, Pontiac and counties: Wayne, Washtenaw, Livingston, Macomb, Monroe, Oakland, and St. Clair. GDAHC was an early leader in quality transparency. It appears that larger hospitals in Lansing and other towns may be included. Medical group data from 2017

Nevada Hospital Emergency Room Prices – Compare (free)

Compare hospital ER visit prices (2014) in Nevada for common reasons people visit emergency departments. Choose illness and hospital (one hospital at a time). Compare to common charges in the county and NV average. For example, a migraine treated in ER typically cost $2961 in NV (and a headache costs $5090). Consumers should note that physician fees are extra, and NOT shown in the website prices. They also need to add inflation factors for 2015, 2016 and 2017. Prices are disease-specific. Nevada PricePoint through NV Hospital Assn.

Nevada Hospital Ratings and Patient Satisfaction Scores

Nevada Hospital Association shows NV hospital performance ratings on Emergency care, Heart care, pneumonia, stroke, COPD, hip and knee, infections, plus patient opinion ratings. Shows 2016-2017 data (some data older, to 2015). Some measures may be the same as at CMS HospitalCompare website, but dates may vary. Scores also for adverse events, surgical complications, mortality, readmissions. Consumers may view 3 or more hospitals side-by-side. Volume levels for certain procedures are given, but questionably labeled to read that lower volume is better.

New Hampshire Physician Visit, Outpatient Hospital and Dental Prices – Compare (free)

Compare physician office visit prices, dental prices, hospital outpatient tests, PT visits and some surgery prices, as well as some ER prices (estimated at 2017-2018 prices plus 5% inflation) in NH. Choose procedure or test (e.g. lab, Radiology such as x-ray, MRI, CT or ultrasound). Select insurance, or uninsured to compare charges with your deductible. Tonsillectomy, colonoscopy and about 20 different surgeries are in Outpatient, which are bundled to include surgeon and anesthesia costs. Price transparency project developed by the New Hampshire Insurance dept. Excellent website, easy to navigate

Texas – Guide to Texas HMO Quality 2017 (OPIC)

Lengthy (270 pages) but valuable report showing detailed clinical quality comparisons between HMO health insurance plans for indicators such as asthma, childhood immunizations, cancer screening, heart care, high blood pressure, diabetes care, prenatal care, mental health care, flu shots, antibiotic utilization rates, rates of physician board certification, and more. Compare HMOs Aetna, Allegian, Cigna, Community First, Community Health Choice, FIRSTCARE, HMO Blue Texas, Humana, Molina, Scott and White, Superior and United Healthcare of Texas. Pub. by TX Office of Public Insurance Council

Virginia Healthcare Prices (2015)

Find average price ALLOWED in 2015 for 30 common healthcare services, including hospitalizations (maternity), outpatient xray/imaging, CT and MRI tests; colonoscopy, mammogram; inpatient or ambulatory surgery (e.g. hernia, gall bladder, knee replacement, tonsillectomy, kidney stones); and ER or office visits. Shows costs but doesn’t identify if it’s facility cost only or INCLUDES the surgeon or other physician fees. Each service shows the average allowed amount that you or your insurance plan paid in 2015. More relevant than most pricing information, but confusing because of the doctor fee questions. From Virginia Health Information (VHI), updated Dec. 2016

Wisconsin ER Prices (Emergency Department)

Find typical charge for common visits to WI emergency departments (ER) or hospital-based urgent care. Examples: urinary tract infection (UTI), or nausea and vomiting or teeth problems. Shows median (middle) price for ER (2018) WITHOUT the physician’s fee, and how many cases the hospital treated. If the hospital has on-site urgent care, it will show that price also. Example: Mercy Health Hospital in Janesville charged $1880 (median) in the ER for urinary tract infection (UTI), but just $514 in its urgent care service. Free-standing community Urgent Care clinics are not included in these prices.   Wisconsin Hospital Association’s PricePoint makes comparing hospital prices possible. Compare hospitals downtown vs. those in the suburbs.

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