OU Medical Center launches extra fee for nonemergency care in ER

[Plutonic Panda]

An Oklahoma City hospital has created an additional fee for patients who seek treatment in the emergency room for non-life-threatening ailments and injuries.

OU Medical Center officials announced Tuesday that, starting this week, adult patients assessed in the hospital’s ER who don’t have emergency medical needs will be charged — either their copay or $200 if they are uninsured — if they choose to still receive care through the ER after that assessment.

“If they choose to continue to get care in our emergency department with a nonurgent situation, then they do indeed have that option,” said Kris Wallace, chief operating officer for OU Medical Center.

“At that point in time, we would ask them to either present their copay or pay a facility fee for nonurgent care in an emergency care setting.”

Hospital officials say the policy change is a result of overcrowding in the emergency room.

- OU Medical Center launches extra fee for nonemergency care in ER | News OK

I really don't have an opinion on this, but was just curious what others thought.

[Of Sound Mind]

Long overdue.

[bombermwc]

Absolutely long overdue. When people treat the ER like their doctor's office, it puts unnecessary pressure on the facilities/staff and causes delays. The hospital is where you go when things are life-threatening, not where you go for free care because you're uninsured and think they will give it to you to meet their quota. People that actually get admitted already meet those, so these people are just mooching.

Where do they go? Urgent Care. They're all over the place. Or even better, go to a doctor. If you're uninsured (which you wont be for long), then you need to pay for the cost of the care and don't expect if for free. Payer mixes at places like OU are HORRIBLE because of people doing this. OU is simply trying to make up some of that cost.

[shawnw]

While I agree it's long overdue, there's a group of people out there that not only use the ER as their regular doctor, but also then don't pay the bills. So, while I love that they are doing this, and do think it will keep some from abusing it, I'm not sure it will fully realize its intent.

[bombermwc]

Just keep in mind that this isn't a new practice. Facilities like OU start doing this when the influx of this type of payor interferes with their ability to treat the actual wounded. Most ER's actually NEED the Urgent Care patients to stay afloat. They treat 10 times as many small cases as "my leg fell off" ones. So don't expect to see other hospitals around town start doing this. St. Anthony might be the next closest thing, but they wont do it unless they open an Urgent Care facility (fast track) separate from the standard ER....and really off-site or something. Obviously they're making money off of the free-standing ER's, which are basically fancy versions of Urgent Care facilities and specifically attract just the patient base that OU is pushing out.

What's different? Payor mix, payor mix, payor mix. = money money money

[HangryHippo]

Just keep in mind that this isn't a new practice. Facilities like OU start doing this when the influx of this type of payor interferes with their ability to treat the actual wounded. Most ER's actually NEED the Urgent Care patients to stay afloat. They treat 10 times as many small cases as "my leg fell off" ones. So don't expect to see other hospitals around town start doing this. St. Anthony might be the next closest thing, but they wont do it unless they open an Urgent Care facility (fast track) separate from the standard ER....and really off-site or something. Obviously they're making money off of the free-standing ER's, which are basically fancy versions of Urgent Care facilities and specifically attract just the patient base that OU is pushing out.

What's different? Payor mix, payor mix, payor mix. = money money money

What patient base specifically is OU pushing out?

[Cocaine]

Hmm I wouldn't have a problem with this if the state had decided to expand Medicaid when the tax for not having medical insurance started. The only other thing I wanna know is who decides what is and what's isn't emergency medical care. As long as they aren't charging someone who is actually having an emergency then it certainly isn't horrible.

[zookeeper]

Hmm I wouldn't have a problem with this if the state had decided to expand Medicaid when the tax for not having medical insurance started. The only other thing I wanna know is who decides what is and what's isn't emergency medical care. As long as they aren't charging someone who is actually having an emergency then it certainly isn't horrible.

I agree with this 100%. The whole thing with the emergency room is we are all told, "If you're not sure and still feel discomfort (or whatever) - get to an ER." What happens when you go and (Egads!) you aren't having a stroke as you feared and end up paying a surcharge for not actually having an emergency?

The sooner profit and healthcare can be separated, the better.

[MWCGuy]

I agree with this 100%. The whole thing with the emergency room is we are all told, "If you're not sure and still feel discomfort (or whatever) - get to an ER." What happens when you go and (Egads!) you aren't having a stroke as you feared and end up paying a surcharge for not actually having an emergency?

The sooner profit and healthcare can be separated, the better.

Basically, you are going to be scene by a nurse, nurse practitioner or Physicians Assistant. If you have injuries or symptoms that require emergency treatment you will be seen. Most metro hospitals are already doing this through a clinic side to the Emergency Department.

One of the biggest problems facing hospitals are people using them as doctors offices when they should be going to an Urgent Care or primary care doctor. In my opinion urgent care is better than an ER for the minor conditions. You don't have to wait all day. In some cases, they give you meds and medical supplies to save you a trip to the pharmacy on the way home.

I think what will eventually happen with the primary care market is that doctors will stop taking insurance and start charging flat fees. Many doctors already do this because they hate dealing with all the insurance paperwork and hate waiting weeks if not months to get paid. What few people realize is that you can find a doctor without having insurance.

My mom needed cataract surgery two years ago. She can't get on medicare or medicaid because of her age. She hasn't worked since she was a teenager. She was a wife and homemaker by choice. My Dad was seriously injured in the oil field and living off workers compensation. I called around until I found a doctor who accepted cash patients. He gave a generous discount because of the fact we could pay cash. He did the procedure at an outpatient surgery center. Today she is seeing 20/20 with no problems.

[bombermwc]

MWCGuy describes what the goal for OU is. Get the things more appropriately suited to a doctor's office, out of the E.R.

I still see my same primary care doctor that I've seen for 15 years, but now I see him online for a flat fee. It's cheaper than what I paid for an office visit WITH insurance! I can do everything I need from my desk at work with a webcam so it's a lot easier to schedule too. That's a good example of what's wrong with how office visits are being billed/treated.

I'm currently in the "uninsured" category because I changed jobs and am not eligible for the new insurance for another month or so. COBRA is ridiculously expensive, so unless someone has a major need, I'm paying out of pocket for all of my stuff (well using the previous job's HSA funds so not really MY pocket). But what I've been surprised at is how much of a discount most places offer. I'm paying barely over what I did with insurance. I was quite shocked. My dentist is an overcharging crap head and I wont be staying with him anyway, so that's another story. Pediatrician offered a 40% discount to pay at the counter on the date of service. Dentist, 20%....even after he over charges anyway (so he could build a new "home" style office and charge for all the new equipment and extra x-rays....so many reasons I'm not staying with him).

I say all that, because I think MWCGuy's view on what the primary physician's world will look like IS going to change. And I feel like it might be more dramatically than most people realize. However, I do think that those physicians that have chosen to set up membership type plans are delusional. Why the heck would I want to pay you a monthly fee to keep a slot with you as a patient...like I'm some toddler in daycare? Just for the "privilege" of being your patient...nope. Not only is it expensive, but it's a load of horse crap and it'd not going to last. The more transparent costs become for patients to be able to shop around, the more that kind of bull honkey is going to go away.

How about instead, lets have every doctor post a price "menu" for their services? Let see what things look like after that gets posted....

[Midtowner]

Hmm I wouldn't have a problem with this if the state had decided to expand Medicaid when the tax for not having medical insurance started. The only other thing I wanna know is who decides what is and what's isn't emergency medical care. As long as they aren't charging someone who is actually having an emergency then it certainly isn't horrible.

Yeah, this is basically a big 'ol f u to poor people. The only place they have for non-emergency care is charity clinics (I don't know if those exist outside of tv shows) and emergency rooms. You take away the emergency rooms, we're going to miss being able to treat the diabetes until someone is having a heart attack or their foot becomes necrotic. This would have made a load of sense in the event Medicaid had expanded as those people could then go to regular docs for that sort of care. I see bad things happening here.

[MustangGT]

Long overdue.

Precisely. Those that use the ER as their personal physician have other options. Insurance or not. Friends who work in ER's report that the clog in the system is folks who don't have to pay use and abuse the system to the breaking point. When it is going to cost them a bit of hard cold cash they might think about wasting the time of an ER with a cold or the sniffles. Because of ObamaCare supposedly there are NO uninsured citizens in America. if you believe that I have ocean front property in Montana.

[Midtowner]

You're not being intellectually honest here. We don't have all of the Affordable Care Act in Oklahoma because we didn't accept the Medicaid expansion. You cannot at the same time take the position that the system doesn't work and further that you support state officials who are actively trying to sabotage it.

[MustangGT]

You're not being intellectually honest here.

Partially true on this thread. However you need to look real hard in a mirror on this quote of dubious intelligence.

[Midtowner]

In other states, the Affordable Care Act is working fine. We now have millions more insured and millions of others with low income covered under expanded Medicaid. It is saving lives. Period. Now you're complaining about it not working in this state while at the same time supporting those trying to sabotage it. And you question my intellect?

[soonerguru]

You're not being intellectually honest here. We don't have all of the Affordable Care Act in Oklahoma because we didn't accept the Medicaid expansion. You cannot at the same time take the position that the system doesn't work and further that you support state officials who are actively trying to sabotage it.

Correct. We got the exchange, which is great, but the Medicaid funding from the Feds would have made a huge difference in getting the uninsured insured. Thanks, Mary, and I hope we get to see your hidden "executive privilege" emails someday Mrs. "Transparency."

[soonerguru]

Precisely. Those that use the ER as their personal physician have other options. Insurance or not. Friends who work in ER's report that the clog in the system is folks who don't have to pay use and abuse the system to the breaking point. When it is going to cost them a bit of hard cold cash they might think about wasting the time of an ER with a cold or the sniffles. Because of ObamaCare supposedly there are NO uninsured citizens in America. if you believe that I have ocean front property in Montana.

Nobody is saying this. No one ever promised this (including Obama himself). But our own Governor rejected hundreds of millions in federal funding that would have helped our chronically poor get insurance coverage through Medicaid, perhaps the biggest aspect of ObamaCare. People on this site aren't stupid enough to fall for cheap Fox News talking points.

[Midtowner]

Not to mention, hundreds of millions added to our economy, which doesn't happen without many many jobs being added to our economy. She's willing to hurt Oklahomans, literally kill Oklahomans to affect political optics. It's sick.

[Plutonic Panda]

In other states, the Affordable Care Act is working fine. We now have millions more insured and millions of others with low income covered under expanded Medicaid. It is saving lives. Period. Now you're complaining about it not working in this state while at the same time supporting those trying to sabotage it. And you question my intellect?

it's saving lives? How do you figure? You do know, before this stupid law came into effect, you could still relieve free treatment

[Midtowner]

it's saving lives? How do you figure? You do know, before this stupid law came into effect, you could still relieve free treatment

As the deadline approached for Congress to pass a continuing resolution to keep the government funded, Republicans refused to strike a deal unless it defunded or delayed Obamacare. Now, a week later, GOP lawmakers still seem unwilling to compromise unless they are able to dismantle some of the health reform law. One Oklahoma resident wants them to understand the human impact of that political position.
On the eve of the looming government shutdown, 26-year-old Kendall Brown published an open letter to the lawmakers who wanted to delay Obamacare for one year before agreeing to pass a funding bill. Brown didn’t mince words. “I am dying, because of the political games you are playing right now,” her op-ed began.

The Oklahoma resident explained that she was born with Crohn’s Disease, an inflammatory bowel disease that has no cure. When Brown was in college, she was removed from her mother’s health care coverage. Since her illness prevented her from being able to take a full course load, she couldn’t meet the credit requirements to qualify as a student to remain on the plan. During that time, she could only afford a limited student health plan, and she accumulated thousands of dollars in medical debt.

Oklahoma Woman Tells GOP Lawmakers: Without Obamacare, 'I Will Be Dead Before My 27th Birthday' | ThinkProgress

If Congress and the Administration had done what you wanted, she'd be dead right now. ObamaCare has saved lives. She can't be the only person who has been saved by being able to purchase insurance with her preexisting conditions. The hatred some of you bear of the poor and sick is pretty disgusting.

[Plutonic Panda]

Oklahoma Woman Tells GOP Lawmakers: Without Obamacare, 'I Will Be Dead Before My 27th Birthday' | ThinkProgress

If Congress and the Administration had done what you wanted, she'd be dead right now. ObamaCare has saved lives. She can't be the only person who has been saved by being able to purchase insurance with her preexisting conditions. The hatred some of you bear of the poor and sick is pretty disgusting.

oh, people say that kind of crap all the time. She could and will get the healthcare she needs. I'm sure Obamacare have saved lives, not in the sense that if we didn't have it, there would be more dead people today.

[Midtowner]

Did you even read the article?

[Plutonic Panda]

Honestly no... I'll read it tonight when I get home. Been out working all day and need some rest.

[Midtowner]

Honestly no... I'll read it tonight when I get home. Been out working all day and need some rest.

I appreciate the honesty.

[Plutonic Panda]

I read it; appears I was just flat out wrong and for that I apologize.

However, I still disagree with parts of the bill even though there are some really good things about it like being able to stay on your parents insurance until you're 26(which it appears the age Brown has reached) and other things like preventing insurance companies from denying you due to existing conditions. Hopefully she can get the treatment she needs. She seems like she is trying and life and is not a bum.