In the ED with a Nonemergency? Pay to Stay, or Walk Away

We all know emergency room waiting areas are choked with patients who could be treated just as well—and in less time for less money—in an urgent care center. That makes it all the more difficult for patients who really need to be there to be seen in a reasonable amount of time. Now Thomas Health System in Charleston, WV, thinks it has found a way to make people think twice about heading to the ED without even considering other venues: If you show up and don’t have a presenting complaint that is truly emergent, you have to pay an upfront copay. They’re certainly not the first, either; as far back as 2012 a report revealed that the number of hospitals charging upfront fees was on the rise. At Thomas, patients will have to submit to an immediate screening; if the screener deems their complaint is not an emergency, the patient can either stay and pay (a minimum of $8, though the “ceiling” would be determined by the patient’s insurance copay) or go to another facility. Thomas does have other clinics nearby. The company estimates that 30% of visitors to its ED have a nonemergent issue.