2016

Primary Care or Emergency Room? The Right Care at the Right Place Lowers Costs & Improves Health

When a patient has a minor injury or illness, their decision of whether to go to a primary care provider or to the Emergency Room (ER) can end up costing or saving the patient and the U.S. health care system a significant amount of money. Patients often go to the ER for issues that can be treated by a primary care provider more cheaply and efficiently because they may not have access to a primary care provider and/or may not know where else to go.

In recent years, the U.S. has spent approximately $3 trillion on health care and each year there are 1 billion physician office visits in the U.S. However, primary care visits only represent 6 to 8 percent of health care spending. By better educating patients about where to go to receive appropriate care for different conditions, and working to increase access to primary care providers, we can save patients and the health care system from costly unnecessary treatments. 

Emergency Room Costs

It is estimated that around 14 to 27 percent of ER visits could be addressed at primary care facilities. That means we’re missing out on a potential cost savings of $4.4 billion annually. Emergency rooms were created to handle life-threatening conditions, such as heart attacks, serious illness, strokes and severe injuries. They are designed to provide specialty care, making their services more expensive. Emergency room visits can be hundreds of dollars depending on your condition and health insurance. However, there are ways to avoid unnecessary ER costs. For example, if you need care after your primary care physician’s office hours, you can call you insurer’s nurse triage line. They can recommend if you should wait and go to your regular doctor or go to the emergency room.

Benefits of Primary Care

Your primary care physician will already have your most up-to-date medical records and will have a copy of your family history. Many providers are also starting to host extended office hours to help better accommodate patients. This allows them to provide better patient-centered, coordinated care, a model that is helping lower health care costs across the country. According to the American Academy of Family Physicians, the highest quality long-term care will be achieved through primary and preventive care.

Preventive care is key to living a healthy life, and is cost-effective. Many insurers will cover a certain amount of preventive care costs, allowing patients to take control of their health and prevent future costly conditions. This results in fewer hospital visits and lower disease rates, in addition to cost savings.

By ensuring patients know where to get the right care, and can access that care, we can lower health care costs and improve our country’s health.