Healthcare Dive: Higher ER prices, case severity boosting spending

Dive Insight:

As ER costs rise, payers are attempting to blunt the impact with controversial new policies that try to reduce unnecessary emergency visits. Some policies, such as Anthem’s, look to move patients away from ERs to less expensive locations like retail clinics. Others, such as UnitedHealthcare’s, are more focused on making sure hospitals are billing properly. Both payers are dealing with provider pushback.

And the emergency care landscape is changing as more freestanding ERs are established and urgent care centers proliferate. Hospitals continue to compete with these on-demand facilities, which have seen some recent controversy. ER physicians disputed the results of a study published last year by the Annals of Emergency Medicine that found ER patients pay as much as 10 times more than urgent care patients for similar diagnoses. The study was later pulled for editorial review. However, other research has shown that ER visit rates have dropped in some states where retail clinics have popped up to provide on-demand care.

HCI’s ongoing research reflects concern over the country’s high — and rising — healthcare costs. Data HCI published earlier this year found healthcare spending per person is growing at a faster rate than previous years, with spending increasing 4.6% in 2016 and 4.1% in 2015, following periods of sub-3% growth between 2012 and 2014.