Freestanding Emergency Rooms Look to Expand in Texas

Freestanding Emergency Rooms Look to Expand in Texas

The occurrence of accidents necessitates the need for immediate medical care. While it is easy to choose the hospital you wish to visit sometimes, being involved in an accident strips down hospital identities. The primary goal of medics at an accident scene is to provide basic first aid and rush you to the nearest ER for further medical care.

This fact among others seeks to explain why free-standing emergency rooms look to expand in Texas. However, this does not in any way imply that accidents are more prone to occur in this state. Many lives have been saved with the help of the ERs in place as they can serve their patients promptly.

A fact is that the free-standing ERs are sprouting out like Texas Wildflowers. Most of the state regulatory standards approve of this setups. The facilities offer quick and efficient emergency care services without the need of going or spanning great distances looking for emergency care centers. Below are some of the vital aspects that have contributed to the drastic emergence of freestanding emergency rooms.

Closure of Hospitals in Rural and Underserved Areas

Unfortunately, hospitals in rural areas are closed down due to high operating costs. Also, free-standing emergency rooms with hospital affiliation showed no interest in making hospitals in such areas. The closure of some hospitals in rural regions has necessitated the intervention of freestanding emergency centers that will readily offer quality services to residents. ERs are also equipped to handle emergency situations hence an early detection of fatal conditions and immediate hospital transfers can be done.

Free Standing Emergency Rooms Target Market

The facilities have been accused of cherry-picking privately and well-insured patients. A significant fact is that most of these services have been set up closer to areas with people who are well off. Regions with people who have higher incomes as well as enjoy excellent insurance packages are the primary target. This way, they can give urgent care closer to these peoples’ homes. However, a simple fact is that most of the health plans are in support of their services despite several complains that the facilities are not able to substantiate their fees.

Ease of Putting up and Running Free Standing ERs

These ERs do not have to meet the rigorous procedures and requirements necessary for starting and running a hospital. Hospitals invest more in equipment as well as staffing before being considered operational. An apparent fact is the cost of running and maintain the two types of medical facilities is without a doubt incomparable. Freestanding ERs are quickly put up and managed since most of their patients can pay for the services offered.

Texas Offers a Ready Market

A harsh fact is that most of the free-standing ERs are meant to generate profits. Yes, it is true that majority of the autonomous ERs are looking to expand in Texas. Several studies indicated that Texas has roughly two hundred ERs of this kind. Most of the facilities are located within the urban area or as close as possible. Only twenty-two percent of these institutions were affiliated to hospitals while seventy-one percent comprised those with the pure intent of making a profit. However, despite all these, the facilities can provide emergency care especially in areas where these services are not easily accessible.

Efficient Services

The emergence of freestanding emergency rooms has given residents a chance to enjoy quick and efficient medical attention. The decrease in the number of hospitals available to the population had a consequential increase in queues in hospitals. Fortunately, patients with less severe conditions can visit ERs instead of crowding hospital rooms.

The laws in Texas seem to be in favor of the facilities as they can quickly offer 24/7 services that most of the urgent care or walk-in clinics cannot provide. Walk-in clinics and critical care facilities often deal with minor injuries such as fever and sprains. ERs, on the other hand, can deal with some surgical procedures as well as trauma. Market research done before the drastic rise in the number of the free-standing ERs indicated that Texas was in need of such facilities.

In conclusion, it is very costly to maintain a full-service hospital more so in a rural area. Emergency care is still necessary for such regions thus the expansion of the ER facilities. Rural areas emergencies are easily managed with the help of free-standing facilities as they can effectively treat and discharge patients with minor conditions. The long waits in hospitals have been seen to decrease as patients can easily acquire quality services. Also, the laws and policies in Texas allow free-standing ERs to operate as they have been observed to help numerous patients. Texas still has more room for the freestanding ERs to be set up as the law and market dynamics allow.

Choose Emergency Care to Avoid Surprise Billing

20 Oct 2017 Health Care

Choose Emergency Care to Avoid Surprise Billing

A surprise medical bill is a bill that occurs when an insured client or consumer encounters out-of-network providers inadvertently at a given in-network facility when receiving medical attention. Most cases of surprise medical billing arise in emergencies where patients can’t select the emergency services they want. Some of these emergency services include; treating physicians, emergency rooms, and ambulance providers. Some of the medical physicians that may not be found in a patient’s network include anesthesiologists, pathologists, radiologists and surgical assistance.

Emergency care refers to the performance of procedures and acts under different emergency conditions. The emergency conditions are always in the care, observation, and counsel of people who may be injured, ill or who have disabilities. The different practices involved are carried out in the presence of licensed physicians who administer care and prescribe medication according to the application and knowledge of biological principles. Emergency care is a process that is not associated with the prescription of corrective or therapeutic measures and the different medical diagnosis acts. It is essential that the various physicians identify the best emergency care procedures and practices to avoid surprise medical billing.

Tips Useful in Avoiding Surprise Medical Bills

To avoid surprise medical bills, you should be equipped with some useful medical tips. The first tip is to check and confirm whether the doctor you are using or the hospital that you are in, is in your network. The second tip is ensuring that you ask for the itemised bill and outline some of the procedures that you didn’t receive. Bellaire ER is one of the best healthcare providers in the world that provides clear cost projections to the customers. An accurate cost projection helps customers and patients to review the bill with more clarity.

Types of Surprise Medical Bills

The most common types of unexpected medical billings are balance billing and preventive care. Balance billing occurs when a healthcare provider bills a patient for the difference between what the provider charges and what the patient’s healthcare reimburses. The advocates of this medical billing argue that the incomes of healthcare providers who provide excellent services are increased. Critics of balance billing say that with this medical billing in place, health providers raise their charges unlawfully through stealth.

Preventive care is a type of medical billing that is tied to the codes used by doctors in the claims that they send to the insurers. Every service that is performed by a medical practitioner is translated into a specific code. The patients and customers get shocked when the physician fails to use the specified systems classified by their insurers as preventive.

Ways of Handling Surprise Medical Billing

In case you get a surprise medical bill, you should not stress so much about it. Keep calm and look for the best way of handling the unexpected medical expense. The first thing that you should do is to check if the state that you are residing in protects the consumers. Most states have laws that protect patients and customers from unexpected medical bills. The state medical laws provide that consumers are required to pay the amount they are owed for the services they have received in-network. The different mechanisms that are used to settle the balance involve the health care provider and the insurer.

The second step that is useful in handling surprise medical billing is reviewing and confirming if the bill is correct. Sometimes billing offices and companies make mistakes because they are dealing with many plans. The providers who are within your network should accept the rates that are contracted by the insurer. You can do some research on the website to estimate the costs of the different procedures if the provider is not in your network. If your employer is your insurance provider, the human resource department may intervene to offer the needed assistance.

To avoid surprise medical billing, you should choose a well-established health care centre. When selecting the hospital that you want to be admitted or treated in, always ensure that they have the best advanced medical facilities and healthcare services. One of the best health care centres that offer some of the best health care services is the Bellaire ER. Bellaire ER, provides emergency services, imaging services, diagnostic services and other wide range of quality services.

In summary, it is crucial for a person to decide on the health care centre he or she wants to be treated or checked at to avoid surprise medical billing. If you encounter unexpected medical expenses, ensure that you are informed about the different ways of managing them. It is essential to choose a hospital or health care centre that offers a wide range of services to patients to avoid out-of-network services that lead to surprise medical billing. People should be informed about the choices that they make to eliminate the extra costs that are associated with unexpected medical expenses.

What is Telemedicine?

What is Telemedicine?

The healthcare infrastructure is drastically changing, and one of the concepts that have emerged is telemedicine. Telemedicine is basically the use of information and telecommunication technology by healthcare professionals to diagnose and treat patients from another location. This concept was introduced to eliminate the distance barriers and make specialized health care services more accessible to the population. Bellaire ER gives more insight on Telemedicine.

History of Telemedicine

The Telemedicine concept was born when telecommunications technology came to be. Radio, telegraph and the telephone emerged late in the 19th century, but it was not until the early 20th century that the population started using these technologies widely. The concept was introduced in the field of medicine in the 1950s when some university medical centers and a few hospitals began sharing images and information using these systems. During the early stages of this concept, it was used to connect a doctor and a specialist working from different locations. It was a great way for people in the rural areas to access specialized medical services.

When the age of the internet came, telemedicine was revolutionized. The practice was characterized by profound changes like the proliferation of more advanced devices that were of offering better audio and imaging transmissions more effectively. Today, the field is constantly changing and at a much faster rate than ever before. With the advancement in technology comes more advanced equipment and more effectiveness in the field. In fact, telemedicine has grown to become an integral part of the US healthcare today.

The different ways Telemedicine can be used
The advancement in internet use has also changed how telemedicine is used. A simple connection to the internet can allow many patients in the remote areas to access to this type of medicine. There are three ways of connection that are used:

• Networked programs
Networked connections are basically used to link up health clinics in the remote places to the large healthcare facilities like the hospitals in the cities. At the moment, the United States has roughly 200 networked telemedicine programs that benefit over 3000 rural sites.

• Point-to-point connection
This type of connection links several small health centers in remote areas to one central health facility using high-speed internet. This type of connection allows small clinics or those that are understaffed to outsource medical care from other locations that are within the same system. This type of connection is particularly common with urgent care service, teleradiology and telepsychiatry.

• Monitoring Center Links
Monitoring center links are specifically used for remote patient monitoring. It works by creating a digital connection between the remote monitoring facility and the patient’s house allowing for the patient’s medical data to be measured at home and transmitted to the medical monitoring facility electronically. The links are usually in the form of SMS, telephone communication or internet. Monitoring Center Links are commonly used when monitoring cardiac, pulmonary or fetal medical data.

Types of Telemedicine

Real-time telehealth
Real-time telemedicine is also called synchronous medicine, and it is perhaps the first line of thinking when telemedicine is mentioned. Real-time telemedicine enables real-time interactions between that patient and the health professional via video and audio communication. The software is quite sophisticated as opposed compared to the video chat platforms people use. However, the concept is quite the same as the goal is for the patient and the health professional to communicate with each other.

Remote patient monitoring
Remote patient monitoring allows the medical practitioners to monitor the vital data of the patient from a distance. It is also called telemonitoring. The popularity of this type of telemedicine is quickly rising as more people realize the benefits of telemedicine on chronic care management. An example is a glucose tracker of a patient that is able to transmit the medical data of the patient with regard to their glucose level to the health official remotely.

Store-and-forward telemedicine solutions
This type of telemedicine, also known as asynchronous telemedicine, enables healthcare providers to forward the medical data of the patient from a different location. They offer a more sophisticated and more secure election platform that allows for a secure transmission of patient’s private data.

Pros of Telemedicine

1. Provides convenient and accessible medical care for patient
The idea of telemedicine is to make medical care accessible to more people particularly for those people in the rural areas. With telemedicine, typical geographical barriers are broken, and the healthcare delivery model becomes more convenient.

2. Cheaper health care costs
Telemedicine has the ability to slash the health care spending greatly by minimizing the need for unnecessary ER visits.

3. Establish better access to consultations from specialists
With telemedicine, health officials have a better platform to engage and consult with regards to the procedures for treating patients. As such, regardless of one’s location, they can access specialized treatments from the best specialists in particular fields.

4. Increased patient engagement
Telemedicine enables patients to connect with their doctors more frequently in a manner that is more convenient.

5. The patient care is also of much better quality given that access to specialized treatment is much easier.

Is Telemedicine Legal in Texas?

Is Telemedicine Legal in Texas?

Texas is one of the states in the US that has been in the limelight with regards to Telemedicine. Texas is known for having a huge segment of its population residing in the rural areas. Given the shortage of specialist in the medical sector, there had been a huge gap created with regard to access to specialized medical services for the rural population. What Bellaire ER and many other residents of this great state see as a step towards the right direction, the government has made changes in the legislation that paves way for telemedicine to bridge the gap that exists.

Telemedicine has been legal in Texas for years now but on a limited basis. For the last six years, telehealth providers have had a difficult time trying to cope with the legislation that initially existed. The emergency rules that were declared by Texas Medical Board required that there be a pre-existing relationship between the patient and the medical professional or a face-to-face communication medium in order to provide telemedicine services. The enactment of these new rules was met with great opposition from telehealth providers who went to court.

The court process has been ongoing for years with the telehealth companies having several victories that in the court against the Texas Medical Board. Sometime in 2016, the board agreed that they would promote legislation in the state parliament that would remove the many hurdles the previous rules created in the path of telemedicine. The legislation to be sponsored would permit telehealth practices, including asynchronous communication in the absence of telehealth presenters and live interactive encounters.

The negotiations resulted in the birth of SB 1107. The bill detailed the following:

A licensed Texas physician is allowed to establish a physician-patient relationship that is valid without having to conduct an in-person exam or the patient having to be in the presence of another health care provider. The bill allowed the physician to use telehealth exclusively in their interactions with their patients using real-time audio and/or visual platforms as well as asynchronous platforms.

The bill required the physicians rendering telehealth to provide their patients with close guidance and the appropriate follow-up care after they have been treated. Also, the physician must seek consent from the patient’s primary care physician – if they have one – and a report of the encounter should be sent to the primary care physician within a period not exceeding three days.

Medical prescriptions are part of treatment and the bill provided room for that. The Texas Medical Board, the Texas Board of Pharmacy and the Texas Board of Nursing are the ones charged with the mandate of establishing the specific rules that would validate prescriptions that are issued through this kind of physician-patient encounter.

The standards of care that govern in-person medical services were the ones that would be applicable for telemedicine and no other standards set by other agencies would not be set for telemedicine services.

With regards to insurance, bill SB 1107 clearly states that telemedicine services only rendered through facsimile or audio interactions will not be affected by Texas Telemedicine parity law. This means that insurance providers in Texas were prohibited from using telemedicine as a ground for restricting coverage with the exception of when the services have been rendered through fax or phone. The insurance providers in Texas were also required to post on their website their telehealth coverage policies as well as their payment practices to allow consumers to determine the amount of coverage available.

Earlier on this year, the Texas Senate approved the bill, and later in May, Texas Governor Greg Abbott put his signature on the bill and signed it into law. This marked a new era for telemedicine in this state and an end to years of legal battle between telehealth providers and the Texas Medical Board. Teladoc was the greatest winner given that it was one of the main parties that engaged the Texas Medical Board in years of court battle. While these companies are the ones that set the stage and triggered the amendments of the initial laws, the bill grants victory to the residents of Texas, particularly those from the rural parts of the state.

With the bill in place and the hurdles in the path of Telemedicine out, the Texas Medical Board is now charged with the task of ensuring that they set and adopt new regulations to govern telemedicine in the state. Some focus areas are:

• Ensuring that the patients who employ telemedicine services receive health care that is at par with the quality standards set.
• Preventing fraud and abuse through telemedicine by setting strong rules with regards to filing claims and keeping records of telemedicine encounters.
• Ensuring that there is adequate supervision of medical professionals to ensure that fraudulent physicians do not exploit unknowing patients.
• Establishing the maximum number of nurse practitioners and physician assistants a physician may supervise.

How Misinformation Prevents the Benefits of Freestanding Emergency Centers

How Misinformation Prevents the Benefits of Freestanding Emergency Centers

The rising healthcare costs are increasingly becoming a headache for citizens, lawmakers, healthcare providers and health insurance providers. Out-of-network healthcare and surprise billing are some of the major problems that the United States is struggling with. Freestanding emergency rooms have been proven to be quite effective and a possible solution to the problem of inaccessibility of healthcare, particularly for people in the rural areas. However, they have been the main target and have been blamed by insurance companies as being the main factor contributing to the rising costs of healthcare.

Freestanding Emergency Centers have grown in number in the last few years. Thanks to that and their increased popularity, more patients can easily access medical care and more conveniently as compared to emergency rooms in hospitals. But the growth has also resulted in misinformation from insurance companies. Bellaire ER argues that the amount of misinformation with regards to freestanding emergency centers ultimately clouds the loads of benefits that these facilities bring.

When you hear the view of a health insurance company, they will say that Freestanding Emergency Centers prefer to remain out-of-network for their own benefits. This is one of the lies that cloud them since freestanding emergency centers have always been open to contract insurance companies. They are often denied when it comes to negotiating their network status to in-network. The few that are lucky to gain the in-network status are usually offered rates that are considerably low as compared to what other licensed emergency facilities are offered.

Consumers are usually on the receiving end when it comes to the consequences of the greed of insurance companies. The freestanding emergency companies require the patients’ treatment bills to be paid for them to be operational. However, since health insurance companies want to ensure that they make bigger profits, much of the medical costs are channeled to the consumers. That is how patients end up with surprise medical bills.

Over the last five years, insurance premiums have increased by almost 20 percent and deductibles by over 60 percent. The same span was characterized by an inflation rate of only 6 percent. This shows the extent by which insurance companies have shifted their focus from ensuring that Americans receive affordable healthcare to generating maximum profits. The huge resistance to keep freestanding emergency centers in-network, increasing the deductibles and the predatory low reimbursements, have resulted in shifting of healthcare costs to the patients.

The federal law and the state law require insurance companies to pay the full in-network benefits for all licensed emergency rooms in the state. This is to be done regardless of whether or not the emergency room has been contracted with the insurer. However, insurers often go against these laws by processing freestanding emergency center claims at out-of-network rates. The result is that policyholders end up being inhibited from accessing their full coverage. The consequent result is higher patient responsibility in the form of a surprise bill. A patient seeking an explanation for the same will always be hit with the false excuse that the cost comes as a result of increase billing by the healthcare providers while the truth is that they have cut their coverage for profit purposes.

Another misinformation from the side of health insurance companies is that freestanding emergency centers confuse their patients with regards to the offered services. Again, this is just a blanket they use to cover the fact that they are driven by the desire to create profits as opposed to providing efficient health care coverage to their customers. The good thing now is that laws are being put in place to prevent this kind of misinformation. In Texas, the law requires freestanding emergency centers to post signage inside and outside of their buildings that clearly state that they are emergency facilities. Additionally, patients have to provide written acknowledgment of the same. This law has yielded very positive results. The Texas Department of Insurance has been receiving fewer insurance coverage complaints.

When the model of freestanding emergency centers was introduced into the United States healthcare system, there was a lot of excitement and optimism that the freestanding emergency centers would help in solving the health crisis in the country. The model helps make emergency health care more accessible to the citizens, especially those in the rural areas, helps reduce the pressure that full-service hospitals are subjected to and saves thousands of dollars of medical expenses since they admit patients at a much lower rate.

However, insurance companies have come to take advantage of the nonexistence of clear guidelines to govern the existing laws. Their focus has always been to make more profits resulting in the derailment of this innovative model of providing emergency care to patients. As such, it is important that lawmakers make it their priority to establish clear laws and guidelines that will ensure oversight of insurance companies. Otherwise, the potential benefits that freestanding emergency care facilities provide will never be enjoyed.

Do Freestanding Emergency Centers purposely saddle patients with surprise medical bills?

Do Freestanding Emergency Centers purposely saddle patients with surprise medical bills?

Freestanding emergency centers have experienced rapid growth in recent years. This only proves that they offer real value for money. Otherwise, patients would have shunned them by now and they would have died a natural death. Despite this growth and the real value, they offer patients, FECs have been the victim of numerous falsehoods. One of the myths that FECs such as Bellaire ER face is that they saddle patients with surprise medical bills. This article will examine this falsehood and seek to dispel it completely.

FECs could actually help to lower the cost of healthcare

A recent study by the University of Michigan, which was undertaken in 2010, found that the average cost of inpatient care was about $35,000 per patient. This is quite a lot for any one patient to bear, considering that they have other bills and that their insurer probably will not cover such a huge bill.

It was found that outpatient ER care could actually help to lower this cost. However, since traditional ERs have an interest in getting patients into inpatient care, this may not always work well. FECs are not bound to any hospital, and they thus do not have an interest in the patient being admitted. It is thus likely that patients will get to go home when there is no need for an overnight stay. This could help them to lower medical costs

Surveys show that it is not the case

Numerous scientific surveys conducted by TAFEC show that a huge majority of patients are well aware of the bills they are supposed to pay. Thus, they do not complain about being hit with unexpected bills. This is contrary to the myth that many patients usually end up with surprise bills.

It is the insurers who are at fault and not the FECs

Under Texas law, there is a loophole, which sometimes leads to predatory behavior by insurers. The law in Texas says that emergency care must be reimbursed to health care centers at a “usual and customary” rate. However, the law is silent about what “usual and customary” means. The insurers thus take great liberty when coming up with a definition for each case. Thus, while some insurers will give adequate reimbursement, others will not.

The FEC is left with the option to collect the debt from the patient or get in touch with the Texas Department of insurance. Some will go to the department, while others will go to the patient. In all honesty, it is the easiest decision as it helps to free them up to run the FEC. The patient can then take up the issue with the department if they feel their insurer acted in bad faith.

Some patients just do not understand the law

The Affordable Care Act makes it clear that all patients have a right to receive emergency care. Thus, a person cannot be penalized for going to an FEC for care. The ACA leaves the determination of what is emergency care up to the patient. Whenever the patient feels they have an emergency, they are at liberty to visit an FEC, whether it is in-network or not.

However, there are numerous health plans that are not compliant with these rules. When making a determination, they do not uphold the patient’s decision to visit the FEC based on their personal assessment. They make their own determination and pay less than they should. This is what leaves patients with surprise bills. However, if patients understood the rules, they would challenge this illegal activity by some insurers. The blame is thus unfairly laid on the FEC.

Billing mistakes occur

Sometimes simple billing mistakes occur. Remember that FECs are open 24/7, which means they are always handling new patients. There is no off peak time during which they can rest and get things in order. It is thus up to you to check the bill carefully to ensure that it contains no mistakes.

Many mistakes may occur including the wrong billing code, wrong procedures, or diagnosis being included, or even the wrong name. A few minutes checking the bill for problems could help to save you many problems associated with an incorrect bill.

The insurance company may be taking its sweet time to pay

Sometimes, some insurers will take their sweet time to pay the bill in the hope that you will pay it. It is morally wrong. It is thus important for you to pursue your insurer when you are hit with unpaid bills. Record every conversation with your doctor and the insurer and pursue them to the end. Eventually, they will fess up if they have no legal ground on which to stand. If your insurer is prone to such games, you may want to think about changing insurers. However, it goes to show that the FECs are not at fault. They cannot be held responsible for the mischievous actions of your insurer.

Are Hospital ERs required to treat all patients?

Are Hospital ERs required to treat all patients?

There are many healthcare providers in the American healthcare system. All of these providers have different functionalities and adhere to different rules and regulations that guide them. Due to this complexity in the healthcare system, it is easy for patients to be confused. Bellaire ER has decided to compose this article to enlighten patients on hospital ERs, how they function and how they differ from other types of ERs.

Hospital ERs

Hospital emergency rooms are the most common type ER. These are emergency rooms that are attached to a hospital and offer quality care to patients with emergency cases.

The hospital ERs differ from freestanding emergency centers (FEC) in that the hospital ERs are located at the site of the hospital while the FECs are physically detached from the affiliated hospital. An FEC also doesn’t have to be affiliated to a hospital as it can be independently run.

Despite these differences, hospital ERs as well as FECs, whether hospital owned or independently run, offer the same kind of medical care for their patients. The emergency rooms provide quality care to patients with a health emergency by prioritizing them an offering quality and timely care.

Hospital ERs also accept Medicare and Medicaid insured patients since they are recognized by the Centers for Medicare and Medicaid Services. This is unlike the independent FECs which are not recognized by this body, and hence they can’t accept the government-run health insurance plans. Hospital ERs are also required to put up notices to inform their patients that they accept Medicare and Medicaid.

Emergency care

The hospital ERs also have to abide by the federal regulations regarding emergency care. The Emergency Medical Treatment and Labor Act (EMTALA) is one of the most prominent federal regulations regarding emergency care. This Act requires the hospital ERs to offer emergency treatment to all patients regardless of their ability to pay. In other words, the hospital ERs are required to treat all patients who visit them with a problem that can be considered as a health emergency.

The hospital ERs should offer the emergency care without discrimination to all people regardless of their financial or insurance status, gender, age or race.

Hospital owned FECs are also required to adhere to EMTALA. In contrast, independent FECs are not required to follow EMTALA, and hence they can deny emergency care to a patient if he or she doesn’t have the ability to pay. However, in some states, such as Texas, there are state laws that mirror EMTALA and require the independent FECs to offer emergency care to all patients.

When a patient visits a hospital ER for emergency treatment, he or she has to undergo proper screening and be stabilized before the hospital can discuss payment with them. In Texas, the law mandates that insurers should reimburse for the cost of emergency care to a patient at an in-network rate even if the hospital ER is out of network. This law also applies to FECs.

Non-emergency care

When dealing with non-emergency care, hospital ERs might turn a patient away if he/she doesn’t have the ability to pay. This is for the privately owned hospitals. Patients with non-emergency cases cannot be turned away at a public hospital ER.


Hospital ERs might be hard to access for many patients. This is because hospitals are usually located on the outskirts of cities. This is one of the reasons why FECs are a necessity. FECs can be located closer to where people are such as in neighborhoods and shopping centers. The quick accessibility provided by the FECs proves critical in emergency situations as every second counts. The FECs, therefore, help to reduce the travel time for emergency cases.

The only advantage when visiting a hospital ER compared to an FEC is in hospital transfers. In hospital ERs, a patient who needs to be admitted is ushered into the hospital with minimal effort. If the ER is an FEC, the patient will need to be transported to the hospital.


Hospital ERs are notorious for overcrowding as many people come here to seek medical attention. The overcrowding causes a strain on resources the staff struggle to offer quality care to all patients.

Since ERs prioritize emergencies over other treatments, people with non-emergency problems can experience extremely long wait times, especially if there is are multiple emergencies.

This is one of the reasons why patients might prefer to visit an FEC instead of a hospital ER. FECs are rarely crowded, and they offer quality care. The wait times in FECs might be less than 10 minutes. Since the FECs are not overcrowded, the doctor can take some quality time to diagnose you correctly. Also, emergency cases can be attended to immediately with the full array of physicians and medical equipment on standby.

In summary, hospital ERs can treat all patients, but they are not required to unless it’s in a public hospital. The hospital ERs are, however, required to treat all emergency patients.

Are Freestanding Emergency Centers real emergency rooms?

Are Freestanding Emergency Centers real emergency rooms?

Freestanding emergency centers such as Bellaire ER in the US have experienced phenomenal growth in the recent past. They offer a model of health care that is committed to speed, quality, and ensuring patients get access to physicians. There have been many misconceptions around these FECs that need to be cleared. One of the popular myths is that they are not real emergency rooms. However, this is just a myth, as the facts presented here will show.

They are bound by the same rules as emergency rooms

The first state to license FECs was Texas, in 2009. Today, it has led to over 200 independent FECs in the state and over 100 hospital-affiliated ones. These FECS are usually found within neighborhoods, and they offer patients care in a timely manner.
The FECs are bound by the same rules as other hospital ERs. The rules that were drafted for the establishment of the FECs are similar to those that govern all ERs in the country. Thus, this cannot be true that they are not true ERs.

FECs cannot turn away any patient who needs emergency care

Just like an ER, an FEC is bound by the law to offer patient care to anyone who turns up at its doorstep. This is quite similar to what happens when you walk into an ER. Whether you are on Medicaid, Medicare or uninsured, you have to be stabilized at the FEC. This has led to millions of uncompensated hours spent stabilizing patients in different stages of distress. It is just more proof that an FEC is the same as an ER.

FECs must have a doctor trained in emergency care present at all times

One of the cardinal rules for any ER is that a doctor, trained in emergency care has to be present there at all times. Otherwise, it cannot be classified as an ER. There are also huge legal penalties for failing to uphold this rule. It is the same in an FEC; a doctor must be on call at all times to cater to patients who need their services.

FECs must be open 24/7, 365 days a year

Even when a hospital has to shut down some of its operations, the emergency room must always be open. This is the same rule as with an FEC. Patients must be able to gain access to it whenever they wish and whatever their situation. The only difference to a hospital based ER is that it does not need to be bound to a hospital. This makes an FEC the same as an ER but even more convenient. Patients do not have to worry about a ride to the hospital when the FEC is located within their neighborhood.

FECs can use the word “Emergency” in their signage and marketing material

This is quite significant proof that FECs are the same as an emergency room. If you check the law, it states that only an emergency room can use the word “Emergency” in its signage and marketing material. This is done to prevent confusing that may arise where patients are led to believe they are at an urgent care center. FECs have been allowed by law to use the word “Emergency.” This proves that they are indeed emergency rooms for purposes of legal definitions.

FECs must have a nurse trained in emergency care present at all times
This is another rule that makes them the same as any other emergency room. When you go to a hospital ER, you will usually find nurses present trying to offer quick care to patients and refer the rest to the doctor. This is the same with an FEC. However, one difference may be that FECs are usually less crowded. Thus, you will still get access to an ER nurse, but one who is under less pressure since they are dealing with fewer people.

FECs can only stabilize patients and refer them to hospitals for inpatient care

If FECs were just any other health facility, they would be allowed by law to provide inpatient care. However, that cannot be possible. They can only stabilize patients before letting them go to a hospital for inpatient care. It is just more proof that an FEC is no different from an ER. In an ER, only patients who are being stabilized occupy beds. Once they are stable, they are shifted to the hospital. This is also, what happens in an FEC. It just proves they are no different from an ER attached to a hospital.

FECs are required to have the equipment used to screen and diagnose emergency room cases

If FECs were indeed different from an ER, this rule would not apply to them. They must have the basic equipment present in an ER. They also have to have staff that can use the equipment to make a diagnosis and to stabilize patients.

What is the Health Insurance System Like in Texas?

What is the Health Insurance System Like in Texas?

Texas leads the uninsured rate in the US. Although the number of uninsured people is steadily declining, 17 percent of the population remains uninsured. The high uninsured rate partly reflects the insurance system in Texas. Bellaire ER sought to breakdown the Texas health insurance system for an in depth look.

Affordable Care Act

The ACA has a significant impact on the Texas health insurance system. Under this act, more people were able to get health insurance, and the number of uninsured people dropped to below 20 percent for the first time.

Part of the reason why there was a drop in the number of uninsured is that the ACA prohibited health insurers from refusing to grant people insurance due to a preexisting condition. Therefore, more people who had preexisting conditions were able to enroll.

The ACA also imposed a tax penalty for those who did not get health insurance. This incentivized people to get insured.

The ACA required states to create a statewide marketplace. Those that didn’t would use the federally facilitated marketplace. Texas is one of the states that have a federally facilitated marketplace. There are also private marketplaces for private insurers who don’t list their plans on the federal exchange.


The Children’s Health Insurance Program (CHIP) insurance cover is meant for children whose parents might not qualify for Medicaid. This might be because the parents’ income exceeds the maximum required income for them to qualify for Medicaid. CHIP has seen most of the children in Texas get health insurance. This has caused a large disparity between the rate of uninsured adults and children. CHIP makes it easy for children to access medical insurance while strict restrictions on Medicaid make it harder for adults to enter the program.


Texas is also one of the states that rejected Medicaid expansion. The expansion was meant to increase the bracket of low income earners that would be able to get health insurance under Medicaid. The expanded bracket includes adults and parents who earn less than 138 percent below the federal poverty level.

However in Texas, since the state rejected Medicaid expansion, adults who do not have disabilities and are not caring for any child do not qualify for Medicaid. Adults who have dependent children only qualify if their household income is less than 18 percent of the federal poverty level.

Private insurers

Texas has a large number of private health insurance providers. Blue Cross and Blue Shield (BCBS) is the largest insurance provider in the individual market. BCBS holds more than half of the individual market share in Texas. Other insurers include FirstCare and Baylor Scott &

There are also national carriers operating in the Texas individual market. These providers include Humana, UnitedHealthcare, and Aetna.

Market plans

There are various market plans for health insurance used in Texas. Exclusive provider organization (EPO), health maintenance organization (HMO), and point of service (POS) are the most common plans. EPO requires you to visit a certain physician or facility within the plan network. HMO covers in-network hospitals and doctors. POS covers healthcare providers within the network and requires you to get a referral to see a specialist.

Preferred Provider Organization (PPO) was a popular market plan before 2016. The plan does not require you to get a referral from your PCP when you need to see a specialist. You can also visit other out-of-network practitioners, but you will have to cater for more out-of-pocket costs.

In 2016 BCBS realized huge losses and decided to discontinue the PPO plan for its clients. Almost all other insurers did the same. Nowadays it has become difficult to find a health insurer offering the PPO plan.

All the plans listed above are mandated to cover emergency costs whether in-network or out-of-network.


Texas still has a large portion of its population that is uninsured. This might be partly due to the following:

Texas hosts a large number of immigrants. This is a major factor for the state since it is located on the border with Mexico. 17 percent of the Texas population is made up of immigrants. Generally, immigrants have the lowest rate of health insurance. Among the immigrant population is the undocumented immigrants. These people cannot acquire health insurance legally, and hence the whole undocumented immigrant community doe not have health insurance.

Medicaid restrictions
Texas has some of the most stringent restrictions on joining Medicaid in the US. The state’s refusal to expand the Medicaid program means that a large portion of low income earners cannot enroll for the health insurance. The low maximum income limit of 18 percent below FPL also locks many people out of the program.

Lack of work insurance
Many small businesses in Texas do not offer health insurance to their workers. Most of these businesses are in the retail, agricultural, and service industries which are unlikely to offer health insurance. Since this is not one of the requirements of the ACA, the rates of the uninsured remain high.

How NASA uses Telemedicine to Care for Astronauts in Space

3 Sep 2017 Health Care

How NASA uses Telemedicine to Care for Astronauts in Space

NASA astronauts often spend months in space when they go for space missions. Every year, a team of astronauts is sent to the International Space Station, and they stay there for a period spanning six months to one year. Given the duration they are out in space, access to medical care is very critical in ensuring that the astronauts are in good health. This is where telemedicine comes into the picture. Bellaire ER gives an insight on how NASA uses telemedicine to care for astronauts in space.

Telemedicine has always been a very key component of ISS’s medical care. Other than helping treat astronauts suffering from minor illnesses and administering urgent care, it also enables diagnostic, therapeutic and preventive care for the while they are in space. It is a means by which the astronauts get a seamless continuity of medical care before, during, and after the space missions. While it is a great way to ensure the safety, well-being and effectiveness of the crew, telemedicine for astronauts comes with a greater need for proper planning and pre-launch training. Rapid learning and good communication are also other important aspects that have to be considered before the crew is sent into space.

The medical support for every space mission organized is usually planned by the NASA team of doctors, nurses, biomedical engineers, psychologists and image specialists on the ground. Each mission has its own unique profile that has to be given careful consideration. This is because the different missions have different needs and come with their own unique medical risks. The work of the grounded team is to determine the materials for trauma and disease prevention, diagnosis of ailments and treatment needed. They are a combination of both tangible and intangible materials. The medicine, the instruments, consumables, and the devices for exercise are tangible material assets while procedures, processes, and protocols fall under the intangible material category. The only way for all these material to work collaboratively and yield positive results that will ensure the health and well-being of the astronauts is by adding effective communication with the specialists on the ground into the mix.

Before launch, the crew is usually trained on how to follow the right procedures and use these medical assets effectively because the crew will not have a doctor on board. The training involves a thorough 40 hours of training using paramedic standards to make that the astronauts qualify as crew medical officers. The training involves familiarizing with foreseeable medical problems and the emergency responses, learning how they can perform a periodic physical examination and knowing when to call for the services of a flight surgeon from the ground.

As stated, rapid learning and effective communication are essential in telemedicine. Given that the provision of health care is a collaborative effort of all the people involved – those on the ground and the astronauts – all the personnel involved including the space crew, the doctors, nurses and the Mission Control team have to undergo training that equips them with the most effective operational communication skills. To further ease the treatment process in case of an emergency, communication is made much easier with the onboard procedure files that help in immediate problem address.

Another integral part of telemedicine is space is where private medical conferences with a ground doctor are held with the aim of discussing the way forward and conducting follow-up procedures in case initial treatment has already been administered. The conference is usually held through a secure connection for evaluation of the ailing astronaut, their diagnosis and treatment. This is because shared knowledge and collaboration ultimately leads to better administering of medical care.

One of the most effective and widely used procedures in space medicine is ultrasound imaging. It has been used to treat astronauts in the past. While it is one of the most developed telemedicine procedures, the approach applied for ultrasound imaging also works for other medical procedures like dental procedures, acupuncture, and minor surgery.

The procedure, planning, execution and the general telemedicine experience that NASA has is a great reference from which lessons can be drawn. With the main focus being the health and well-being of the astronauts, the process effectively combines all the required medical resources, effective training of the personnel and effective communication. The end result is effective health care for the astronauts for the period they will be out in space.

This can be a great reference point and a way for medical practitioners to provide effective and reliable telemedicine care to people in the remote part of the US and the world. The internet is constantly growing, and technology is continually evolving. This provides a greater platform for telemedicine physicians to make their services more accessible and more effective given the ease of communication. It is becoming increasingly possible to communicate in real-time, and the space exploration and improvement of NASA’s telemedicine may just be a way of improving healthcare on earth too.

1 2 3