A rural out-of-town 157 life group health plan in deep South Texas incurred 98 budget busting ER visits during the past 12 months most of which could have been avoided.
Plan members seeking “emergency care” must drive 30 miles before reaching the Ed Carey Drive exit off US 77 hwy. As they travel down Ed Carey Drive towards the care they need they have one of two choices to make. Do they take a left or right on Pease Street?
Records show 98 plan members took a right on Pease Street to the Valley Baptist ER. And they didn’t get there by ambulance.
Most of these visits, in fact all of them if truth be told, could have been avoided at substantial savings to both plan members and plan. The ER copay is $500, money most don’t have. In addition, the plan pays thousands more than that, money that could have been better spent elsewhere.
What these plan members didn’t know is that if they had turned left on Pease Street it would have cost them nothing. The South Texas Urgent Care Center has a direct Medicare based Agreement with the plan sponsor. All patient financial responsibility is waived. No copay, no deductible, no coinsurance, no kidding.
Average cost of an urgent care visit is less than $200. Average cost of an ER visit is +$2,000.
Meanwhile, two blocks away from free care the Valley Baptist ER cash register smokes from overuse, cranking out enormous budget busting bills most can’t afford except yacht dwellers.
“Turn right and pay $500. Turn left and pay nothing.” What would you do?
Additional Reading Assignment: Aldeen’s Sunday Morning Bathroom Read
