Survey of Texas Freestanding ERs Reveals Misleading Practices and Consumer Confusion

| December 18, 2018 | Health, LEAD STORY, Medical, NATIONAL, NEWS | No Comments
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AUSTIN, Texas—A booming health care industry is confusing Texas consumers and leaving families with uncovered medical bills, according to a statewide survey by AARP released today.

Unlike urgent care clinics, freestanding ERs are generally not “in network” for any insurer. It’s common for consumers to receive surprise medical bills after treatment—without knowing the cost of their treatment in advance.

Despite the fact that Texas law requires health care providers to inform patients about their plan’s coverage and the potential costs of care, consumers continue to face problems.

To better understand the situation, AARP conducted a “secret shopper” survey, reaching out to 213 freestanding ERs across the state. The findings paint a picture of widespread problems:

  • Less than half of facilities were able to answer a simple “yes” or “‘no” question about health plan coverage over the phone.
  • 28 percent of facilities known to be out-of-network used confusing language during these phone calls, indicating they “take,” “accept” or “honor” insurance.
  • 30 percent of websites do not appear to fully comply with state disclosure laws (SB 425 and HB 3276).
  • 77 percent said they “take” or “accept” insurance on their website but were actually out-of-network for any major health plan.
  • 60 percent of freestanding ERs used disclosure language that suggests the facility is in-network when it is, in fact, an out-of-network facility for all health plans.

“The data show that freestanding ERs need to be more transparent,” said Bob Jackson, AARP Texas director. “Without further legislative action, the problem is likely to get worse. We support legislation focusing on improved disclosures and better patient protections.”

NOTE TO EDITORS: AARP has also produced a “The Truth About Freestanding ERs” infographic that can be found here: https://states.aarp.org/wp-content/uploads/2018/12/aarp-texas-freestanding-er-survey.pdf You are welcome to publish the survey with attribution. For questions or an interview with an issue expert, contact Natalia Ciolko at 512-605-9747 or nciolko@aarp.org.