Freestanding Emergency Departments (FSEDs) have experienced explosive growth over the past decade. In 2001, FSEDs comprised only 1% of total US emergency departments compared to 11% in 2016 according to Becker’s Hospital Review. This growth shows no sign of abating–the 2023 estimated market size of USD 11.55 billion is projected to grow to USD 15.2 billion by 2029 (United States Freestanding Emergency Department Market Size & Share Analysis – Growth Trends & Forecasts (2024 – 2029).
What is driving the dramatic increase in FSEDs? They obviously present a huge business opportunity which many private companies, hospitals, and even physicians themselves are taking advantage of. On the patient side, freestanding emergency departments offer a number of benefits, driving more and more people to seek care at FSEDs every day. While there are advantages to FSEDs, there are also important risks patients should consider. Here are several pros and cons to freestanding emergency departments for patients:
Pros
Convenient Access:
One of the primary benefits of freestanding emergency departments is their accessibility, particularly in larger cities that have significant “urban sprawl.” These standalone facilities are strategically located to provide timely medical attention, especially in emergencies where every minute counts. FSEDs can be lifesaving, offering critical care fast.
Reduced Wait Times:
reestanding emergency departments are renowned for their efficiency in delivering prompt medical services. Unlike traditional hospital emergency departments, which are frequently overcrowded with long wait times, freestanding emergency departments often have shorter wait times and streamlined processes. This efficiency translates into faster diagnoses, treatments, and can lead to better outcomes for patients facing acute medical conditions.
Specialized Services and Equipment:
To obtain competitive advantage, many FSED owners invest in state-of-the-art equipment which enables them to offer specialized services and expertise tailored to specific medical emergencies. This advanced diagnostic equipment may not be available in the local hospital emergency department which could mean travel to another health care center or, more concerning, a less accurate diagnosis.
Cons
Limited Inpatient Services:
Unlike hospital-based emergency departments, freestanding emergency departments are typically not equipped to provide inpatient care or extensive medical interventions beyond the initial stabilization of patients. This limitation means that individuals requiring hospital admission or complex medical procedures may need to be transferred to a larger hospital, resulting in potential delays in ongoing treatment and continuity of care.
Regulatory and Quality Concerns:
The proliferation of freestanding emergency departments has raised concerns about regulatory oversight and quality assurance. Unlike hospital-based emergency departments, which are subject to rigorous regulatory standards and oversight, freestanding emergency departments may operate under less stringent regulations in some jurisdictions. This variance in regulatory oversight can raise questions about the quality of care provided, including issues related to staffing levels, equipment maintenance, and adherence to clinical protocols.
Cost Considerations:
From the cost perspective, freestanding emergency departments come with a number of potential downsides. While many FSEDs often charge fees similar to those of hospital-based emergency departments, freestanding emergency departments are frequently out-of-network for private insurance which can lead to significant out-of-pocket expenses. In addition, many freestanding emergency departments do not take Medicaid which means huge medical costs for the most vulnerable populations.
Wrap-Up
The exponential growth of freestanding emergency departments over the past decade highlights the significant business opportunities they present for private companies, hospitals, and physicians alike. From a patient perspective, FSEDs offer undeniable benefits as well as drawbacks. As FSEDs continue to proliferate, it is essential for patients to weigh these pros and cons carefully when seeking emergency care. Moreover, policymakers and regulatory bodies must address concerns surrounding oversight and affordability to ensure that patients receive high-quality, accessible emergency services without facing financial hardship.
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