Do Healthcare Costs Rise or Fall With Freestanding Emergency Departments?

MedicalResearch.com Interview with:

Murtaza Akhter, MD Assistant Professor Department of Emergency Medicine University of Arizona College of Medicine Phoenix 

Dr. Akhter

Murtaza Akhter, MD
Assistant Professor
Department of Emergency Medicine
University of Arizona College of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Recent years have brought a significant increase in emergency department visits, and therefore also a boon in openings of freestanding emergency departments (FrEDs). However, it is has been unclear whether the opening of FrEDs reduces healthcare costs. Our study showed that in increase in FrEDs was associated with an increase in spending per Blue Cross Blue Shield enrollee.

MedicalResearch.com: What should readers take away from your report?

Response: Opening up freestanding emergency departments can have various effects, and that often times it can lead to increased healthcare costs. This is often due to increased utilization, thereby making freestanding emergency departments supplements to hospital-based EDs rather than substitutes. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: One important aspect to look at would be how regulations in various states affect FrEDs, and in particular healthcare costs. It is very possible that the rules stipulated by each state on where freestanding emergency departments can be opened affect how effective they are.

Another topic needing more research is how much of the costs related to opening of FrEDs are related to in-network vs. out-of-network physicians.

Thirdly, a closer look at how a patient is directly affected by the opening of freestanding emergency departments would be a useful analysis; our study found that out-of-pocket payments were even reduced in one of the four states, as one example.

MedicalResearch.com: Is there anything else you would like to add?

Response: No conflicts of interest. Dr. Ho has received financial support from The Sid W. Richardson Foundation at Rice University’s Baker Institute and Dr. Xu received financial support from the Karen Davis Endowment in Rice University’s Economics Department.


Vivian Ho, Yingying Xu, Murtaza Akhter. Freestanding Emergency Department Entry and Market‐level Spending on Emergency Care. Academic Emergency Medicine, 2019; DOI: 10.1111/acem.13848 

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Last Updated on October 24, 2019 by Marie Benz MD FAAD