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State Considers Halting ER Boom

John Ryan

Swedish Medical Center is opening a new emergency room today in Mill Creek, south of Everett. It's part of a construction boom for emergency rooms that are not attached to any hospital. As KUOW's John Ryan reports, there's a move in Olympia to bring that boom to a halt.


Mill Creek is the third stand–alone emergency room to open in the suburbs north and east of Seattle. Four other freestanding ERs are in the works, all on the east side of Lake Washington.

Officials at Swedish and the other hospital chains behind the construction say it's an overdue response to decades of population growth on the Eastside. John Milne is a vice president at Swedish.

Milne: "Many of the health care facilities are aligned on the western half of those counties, along old Highway 99, when they were built in the 40s and 50s, when that was the major north–south thoroughfare."

Milne was testifying at a recent hearing on a bill to put a two–year moratorium on construction of any freestanding ERs in Washington state.

Critics of the construction boom say it unnecessarily drives medical costs up. Don Stewart is a primary care physician in Sammamish. He says when you build ERs, that's where people will go. Convenience will trump the slightly higher co–pay they might face.

Stewart: "They can get all sorts of tests that they wouldn't be able to get in the primary care doctor's office because they don't have to get insurance pre–authorization because it's emergency care. So we see things costing five, six, $8,000 for visits that could easily be taken care of in a primary care office for $150. I see this all the time."

Joe Gifford is a senior medical director with Regence Blue Shield. He rattled off some recent claims the insurance provider had to cover at a freestanding ER.

Gifford: "And we have ankle sprain, over $700, sore throat, over $600, sprain of hand, over $800, cut to finger, over $1,300. These claims do have to be paid no matter what."

Boyle: "We all agree that we need to find solutions to reduce overutilization of the emergency room."

Teresa Boyle is a vice president at Multicare in Tacoma. She says hospitals are making great efforts to see that emergency rooms are used for emergencies only.

Boyle: "Despite all these efforts, there remains an increasing demand for emergency–care services as the population of the state grows. I would also add that if the state health programs like Basic Health, Disability Lifeline, and Apple Health for Kids are eliminated or cut, the utilization of emergency rooms is also going to increase."

Cheryl Pflug proposed the moratorium. She's a Republican state senator from Maple Valley — and a nurse. She says the freestanding ER boom isn't driven by the needs of low–income patients, like those on Medicaid.

Pflug: "So we're not talking about expanding facilities in White Center, or Holly Park or Chelan County. Let's just be honest that this has nothing to do with serving Medicaid clients."

Pflug says the nonprofit hospitals behind the new ERs are just competing for market domination and for the chance to steer more customers to their main operations.

I'm John Ryan, KUOW News.

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