Growth of freestanding EDs raises concerns about cost

Stand-alone EDs, which are often located near high-end shopping centers and target consumers with private insurance, bill like regular emergency deparments. Insured patients have little incentive to drive past more expensive, freestanding EDs because their co-payment is only $50 or $100, modestly more than what it might cost for a visit to an urgent-care center or doctor's office. Their insurers pay the balance. Insurers have little power to stop patients from using the facilities because by state law, they must pay for ED coverage any time a patient perceives they have an emergency, regardless of whether that turns out to be the case. For that reason, the freestanding EDs have no need to contract with insurers and offer discounts.