The Hospital ER As Main Selling Point : Facilities Market Wait Times – And Prompt Concerns

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Despite years of concern about crowded emergency rooms, many California hospitals have embarked on aggressively courting patients to their ERs – a nascent campaign that has raised concerns among healthcare advocates and providers.

At least 10 for-profit and not-for-profit facilities have in recent months begun marketing their ERs as a selling point for swifter healthcare delivery.  This is despite the fact a new Press Ganey report concludes ER waiting times continue to increase statewide (see In Brief, page 2).

The marketing campaigns include:

•Hospital Corp. of America’s five hospitals in California are using a texting service for patients to determine ER waiting times. The waiting time of the closest hospital is sent to the would-be patient’s phone, or they are urged to call a toll-free hotline for more information.•Loma Linda University Medical Center offers a service for patients to make ER appointments online for a $25 fee.

•Two Tenet Healthcare Corp. hospitals – Sierra Vista Regional Medical Center in San Luis Obispo and Placentia-Linda Hospital in Placentia – have begun posting waiting times on its websites.

Other hospitals are also marketing their ERs through mailers to prospective patients. Their content suggests the hospitals are trying to displace primary care physicians or community clinics as providers of non-emergency care.

One consumer mailer, sent out by Petaluma Valley Hospital in Sonoma this month, boasted that “our average wait time is anything but average.” It also touted free parking and provided a map.

“We wanted to seek to appeal to a base of consumers beyond the Petaluma Community,” said hospital spokesperson Katy Hillenmayer. She added the hospital recently reconfigured its ER operations to reduce waiting times.

“There is a faster turnaround time for ER services here, and if a patient is equidistant between our hospital and another facility, they should consider our hospital,” Hillenmayer said.

Hillenmayer disputed that the mailer was encouraging patients who do not have a medical emergency from using Petaluma Community’s ER. That’s despite the fact the mailer contains a warning that those with “life threatening emergencies” should call 911 – an option that tends to eliminate hospital choice.

Nonetheless, such marketing appears to be the wave of the future for the state’s hospitals. According to the California Hospital Association, 80% of hospital admissions come through the ER, compared to about 50% a couple of decades ago. That means the ER can be a significant source of revenue if managed deftly.

“Despite all the protestations about hospitals losing money on their ERs, it serves as a loss leader for them in terms of bringing in new business” said Anthony Wright, executive director of Health Access, a patient advocacy group.

Wright considers the marketing of ER wait times as good for consumers, particularly in congested urban areas such as Los Angeles. But he and other advocates raised a concern that such marketing may encourage the inappropriate use of ERs and cherry-picking of paying patients.

“It’s a good business decision if they’re targeting insured patients,” said Judy Dugan, director of research for Consumer Watchdog, a Santa Monica-based advocacy group. “But it’s the opposite of what the healthcare system needs.”

Dugan noted that many patients are charged co-payments and other fees they would not incur if they visited their primary care physician or an urgent care clinic.

“We’re not allowed to give discounts for ER care,” said Ron Yukelson, director of business development for Sierra Vista.

The cost concern was echoed by the California Association of Physician Groups, which represents many primary care doctors statewide.

“It’s good customer service, it’s transparency, it’s consumerism, and I think you have to applaud that,” said William Barcellona, the CAPG’s vice president of government relations. “I would just hate to think that patients who get access to medical groups for free would get into a queue at the ER.”

Barcellona noted that on January 1, most of the state’s medical groups must comply with timely access regulations that would prompt them to provide same-day care.

He added that many medical groups have been marketing their quick appointment times. However, they must compete with hospitals that are open around the clock, and it appears they are going to tout that advantage.

Meanwhile, hospitals such a Sierra Vista are taking a close look at the program launched by Loma Linda. It uses software created by InQuickER, a Georgia-based firm that helps schedule ER appointments online for seven hospitals, mostly in the Southeastern U.S.

“We’re a small community hospital in a rural area, and we have to keep the lights on,” Yukelson said. “Our goal is to have or drive a paying patient here.”

Consumer Watchdog
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