Free Standing ED's In NYC: Can It Work?

[x635 4,066]

This article is a few months old, but I just came across it and it is quite interesting:

http://www.crainsnewyork.com/article/20110403/FREE/304039965

Free-standing ED's are becoming popular here in TX, especially in communities that can't support full hosptials yet. EMS has criteria, and can transport to a free standing ED. They have everything an ED has- CAT scans, lab, etc....but if a patient needs a higher level of care, they get transported to a hospital.

[Guest mjs7fd]

it may not work in urban areas because of the close proximity of the hospitals but it could work in some suburban and rural areas where some places are 20 plus miles from the nearest hospital.

[16fire5 693]

I agree about the rural areas needing them more than NYC. If I'm not mistaken St. Lukes Cornwall Hospital Cornwall Campus is a free standing ER now.

[mfc2257 464]

I know some folks that have owned them over the years. They work in the right environment. They can work in urban areas. The key is how fast can you see the patient and what are your outcomes. They don't work if you are trying to create a trauma center without the associated support services.

There are a million variables that go into the success or failure. How much charity care will you provide? How much bad debt will you carry? What will your Medicare utilization be? Who else will you contract with. Is it a CON state? What is the cost of acquiring your CON which varies widely by state. What is the payor mix? Would it be better to license a few beds and become a critical access hospital and get cost based reimbursement?

[PEMO3 523]

I do not see why a free standing ED or "emergi-care" center cannot work in NYC. Lets face facts, EDs have become glorified doctors offices for those without primary health care providers and/or insurance. More often than not they are packed with patients complaining of flu like symptoms, minor wounds, etc, and most are treat and releases. While this is not to say that there are not the serious patients that do present to the ED such as MIs, stabbings, auto accidents, etc. by and large the volume could be treated in a free standing ED. The problem would arise in the 911 system as to can an ambulance legally transport to a freestanding ED. I am not sure where that would go.

[SRS131EMTFF 471]

Not that I have much experience in hospital administration but sounds like we are talking about the Triage or Fast-track patients, thus wouldn't free standing ED be a misnomer?

[INIT915 1,119]

Not that I have much experience in hospital administration but sounds like we are talking about the Triage or Fast-track patients, thus wouldn't free standing ED be a misnomer?

Not a misnomer at all. That's exactly what they seek to be, a full-service independent ED. There are pros and cons (I see more cons in my experience.) Ideally, free standing facilities should limit themselves to urgent care and leave the true, traditional full-service ED's for higher acuity cases and EMS transports.

[ny10570 745]

This is going to become an intox/BS sick job dumping ground. Hell, Vinnys was an intox dumping ground before it closed. Manhattan hospitals are not so far away that you cannot skip to a fully equipped facility without causing harm. Besides, the patients where time really matters will be going to the same hospitals as before. This is a clinic that accepts ambulances, not a whole lot more. I have a hard enough time selling patients with legit medical complaints on the benefit of going to a nearby hospital and then getting transferred to their doctors facility in LI or Jersey.