PRESENTS:
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THE TYPICAL EMERGENCY ROOM VISIT
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CHARGES, WAIT TIMES, & TIPS FOR
AVOIDING HIGH COSTS
Of the approximately
2.6 trillion dollars
that are spent on health care in the
United States each year (an amount
that continues to rise), some estimates
suggest that emergency care accounts
for up to 10% of the total.
ALL OTHER U.S. HEALTHCARE
EMERGENCY CARE SPENDING
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The number of emergency
room visits has been rising.
2010
130,000,000
2011
136,000,000
+18.7%
From 2012–2013, the 24 busiest
emergency rooms in the United
States reported 18.7% more visits.
From 2010–2011, visits increased
from 130 million to 136 million.
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Although different regions of
the United States have different
common reasons for ER visits,
ABDOMINAL
PAIN
abdominal pain, respiratory
RESPIRATORY
INFECTION
infections, superficial injury,
and sprains/strains are the
four most common reasons
that people visit emergency
SPRAINS &
STRAINS
SUPERFICIAL
INJURY
rooms across the country.
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Across the United States,
patients spend an average
of 24 minutes waiting in
the emergency room
before seeing a doctor,
and 2 hours, 13 minutes
at the hospital before
being sent home.
0 0: 2 4:0 0
0 2: 1 3:0 0
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According to an NIH-funded
study, the median ER visit
across the U.S. costs $2,168.
$2500
$2000
$1500
$1000
That’s about 40% more than
what the average American
pays in monthly rent.
$500
AVERAGE
MONTHLY RENT
IN THE U.S.
AVERAGE
ER VISIT IN
THE U.S.
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However, the same study found
that the difference between the
PERCENTILE OF EMERGENCY ROOM CHARGES
25th and 75th percentile of
$?
charges was $1,957; this means
0
$1,957
25
50
$?
75
100
many patients are paying a lot
more or lot less than that for an
ER visit, which makes it nearly
YOUR BILL?
impossible to know how much
you will be billed.
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The study also outlined the
differences between minimum
and maximum charges for
various health issues.
The minimum charge for people diagnosed with
sprains or strains was $4, while the maximum
charge was $24,110. For those diagnosed with
headaches, the minimum charge was $15 while
the maximum was $17,797. For those diagnosed
with a urinary tract infection, the minimum
charge was $50 while the maximum was $73,002.
SPRAINS
UTI
HEADACHES
$50
$1000
$5000
$10,000
$25,000
$75,000
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33%
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In 2012, 33% of Americans
said they had to put off
medical care for themselves
or their family due to cost.
For those without
insurance, 55% said they
had to put off health care.
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For those with private
health insurance, 30%
said they put off
health care.
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For those with Medicare
or Medicaid, 21% said
they put off care.
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HOW TO Avoid High Emergency Room Costs
First of all, it’s important to know that the charges billed are not actually what most people pay; Dr. Jesse M.
Pines, an associate professor of emergency medicine and health policy at the Center for Health Care Quality
at George Washington University explains, “the prices on the bill are just a starting point… [they] don’t
represent what the insurer or patient will ultimately pay.”
TIP #1: Only go to the ER if you need to
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Approximately half of emergency department visits are
not for emergencies. One way to avoid the high costs of
going to the ER is to call your doctor first and ask for
advice if your situation is not actually an emergency;
alternately, you could go to an urgent care center, which
is usually faster and cheaper than using an ER.
TIP #2: Be an advocate for yourself in the ER
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If a health care professional suggests or orders a test or procedure
during your visit, ask about its benefits and risks—and ask if it is
completely necessary or if there are alternatives.
TIP #3: Review and ask about your bill
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Mistakes in billing happen regularly. Duplicate charges,
charges for canceled tests/procedures, and unreasonable
charges for time spent in a room (when you are admitted at
11:00 PM on Tuesday, discharged at 3:00 AM on Wednesday,
and billed for two full days) are all fairly common.
TIP #4: Negotiate your bill
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As is clear from the information above, the amount that hospitals
and doctors charge varies widely, and hospitals know this. You can
definitely negotiate your final bill. Some hospitals offer discounts
for cash payment or other payment options if you don’t have
insurance. You can also call the individual doctors who saw you
during your visit and negotiate with them. You can even negotiate
if you have insurance.
TIP #5: Don’t wait to dispute your bill
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Billing takes time, and payment is expected promptly. If you
wait to contact a hospital about your bill, they may report it
to a collections agency, which can ultimately affect your
credit score and cost you a lot more in the long run due to
your damaged credit.
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REFERENCES
Alderman, L. (2010, August 6). Demystifying, and maybe
decreasing, the emergency room bill. The New York Times.
Retrieved from http://www.nytimes.com/ 2010/08/07/health
/07patients.html?_r=1
Lee, M. H., Schuur, J. D., & Zink, B. J. (2013, April 26). Owning
the cost of emergency medicine: Beyond 2%. Annals of
Emergency Medicine, 62(5), 498-505. DOI: http://dx.doi.org/
10.1016/j.annemergmed.2013.03.029
Caldwell, N., Srebotnjak, T., Wang, T., & Hsia, R. (2013, February
27). “How much will I get charged for this?” Patient charges
for top ten diagnoses in the emergency department. PLOS.
Retrieved from http://journals.plos.org/plosone/article?id=
10.1371/journal.pone.0055491
Preidt, R. (2014, November 25). ER visits on the rise, study
reports. Medline Plus. Retrieved from http://www.nlm.nih.
gov/medlineplus/news/fullstory_149653.html
Fernandez, E. (2013, February 27). How much will I be charged
at the emergency room? UCSF study examines wide range of
ER bills, highlights need for better-informed patients. University
of California San Francisco. Retrieved from http://www.
ucsf.edu/news/2013/02/13576/how-much-will-i-be-chargedemergency-room
Groeger, L., Tigas, M., & Wei, S. (2015, January 14). ER wait
watcher: Which emergency room will see you the fastest?
ProPublica. Retrieved from http://projects.propublica.org/
emergency/
Sandler, M. (2015, January 17). ER visits still rising despite ACA.
Modern Healthcare. Retrieved from http://www.modernhealthcare.com/article/20150117/NEWS/301169969
Spross, J. (2012, December 14). Over one in three Americans
forgo health care due to costs. Think Progress. Retrieved from
http://thinkprogress.org/health/2012/12/14/1337261/one-inthree-put-off-care/
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