Don't Waste Your Money
Avoiding E.R. Sticker Shock
Outpatient treatment costs vary greatly, and patients often have no idea what to expect.
By Dr. Sanjay Gupta
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The last thing on most people’s minds when they find themselves in an emergency room is, “So how much is this going to cost?” But E.R.-associated expenses can be incredibly steep — think for two Tylenol. Even though about one in five Americans will visit an emergency room this year, most patients have no idea what the damage will be until the hospital’s (usually very confusing) bill arrives in the mail.
Compounding the situation, according to a recent study led by UC San Francisco, is the fact that patient charges for the most common outpatient treatments in emergency rooms vary widely nationwide. Researchers reviewed an estimated 76 million emergency department visits between the years 2006 and 2008. The study, which was published online in PLOS ONE, focused on adults 18 to 64 years old and looked at their total E.R. charges — medical care, tests and treatment.
The differences in patient costs were staggering. Out-of-pocket charges for sprains and strains ranged from to ,110. Treatment for a headache could run anywhere from to ,797. And charges associated with treating an intestinal infection ran the gamut from to over ,000.
How a condition is treated and what tests are ordered can contribute to dramatic price variations. What hospitals charge can also fluctuate depending on differences in provider reimbursement.
Even geography can be a factor. A 2012 UCSF analysis of charges at California hospitals found huge variations across the state, and county hospitals tended to be less expensive than nonprofit and for-profit hospitals.
Certainly, hospitals can do a better job of being transparent about the costs of certain procedures and tests, and patients can help contain costs and unnecessary surprises as well.
For starters, use sound judgment about when you need emergency room attention. Some situations dictate the need for immediate treatment, and a genuine emergency often means not having the luxury of choosing when and where you get medical care. But for less urgent or time-sensitive conditions, patients should consider first reaching out to their doctor for advice. There may also be treatment options that are less costly than the E.R., such as a local urgent care center.
When the situation dictates that you seek emergency room treatment, try to ask about charges upfront. The answer may not be entirely satisfying, but it could cut down on the surprise when your bill arrives. You may also want to speak to your insurance carrier about what coverage to expect. Finally, when you do get the bill, study it very carefully — billing mistakes, after all, do happen.
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