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Unplanned Medical Events

by Joan Bachman

Friday afternoon -- the cough is worse, the pain increased, or the vomiting persists. It started yesterday but a good night’s sleep didn’t bring expected relief. What to do? We’ve each been in that position personally or with a family member or client.

This piece is prompted by an article, ER Treatment Can Lead to Surprise Medical Bills, in my hometown newspaper. The author is Trudy Lieberman of the Rural Heath News Service.

Medical emergency: an acute injury or illness that poses an immediate risk to a person's life or long-term health. Wikipedia

Urgent Care: medical care provided for illnesses or injuries which require prompt attention but are typically not of such seriousness as to require the services of an emergency room. Merriam-Webster

A quick internet research revealed the following financial information: (I did NO study of sources)
National average for ambulance transportation $600 - $1,000 plus mileage and supplies
National average for air ambulance transfer $12,000 - $26,000
National average for emergency room $1,233 - $2,168
National average for urgent care $150

Although insurance may cover the bill, unnecessary use of emergency services drives up costs for the provider and the insurance carrier. Urgent care or outpatient services have become more available for unplanned medical events, but such service may not be available in all locations.

Many of us are responsible to assist a family member or client to access medical services for an unplanned medical event. Most of us can recognize a true emergency: symptoms of a heart attack, major accident, sudden bleeding, etc. It’s the non-critical events considered here.
1. Is this condition dangerous to immediate or long term health?
2. What did the person do the last time this happened?
3. What medical services are reasonably available?
4. How will the person access the service?
5. What can be done to manage the event until medical care is accessed?
6. What might be the cost difference between choices?
7. Who will pay for whichever of the services is selected? Cost may not be the deciding factor for proper treatment, but should be considered.

Because of the current cost of medical care, changing health plans, and the difficulty of finding a compatible provider, the answers would be easier with prior planning. To help develop the plan for a future unplanned medical event, you might contact the local hospital or clinic to ask about available unscheduled medical services, such as urgent care or outpatient service. At the next scheduled appointment with the primary care provider, ask questions about what medical care is available in case of a need for unplanned medical services. The provider may have suggestions for preventing or managing some unplanned medical events. Arrange to have approved remedies available and inform family or caregivers.

Questions to consider when devising a plan of action in the event of a future medical situation:
1. Are primary provider recommended remedies on hand?
2. What medical services are available?
3. How can medical services be accessed?
4. What services does insurance cover? How much will be paid by insurance?
5. What will be the cost if there is no insurance? Who pays?

The health care decisions we make have an effect on a person’s physical health – and also financial health. Over the course of a year, individual decisions for treatment of unplanned medical care by many people can have a major effect on the direction of local and national health care costs. 


About the Author

Joan Bachman

Joan Bachman is a Registered Nurse, Licensed Nursing Home Administrator, Registered Health Information Technician, and Faith Community Nurse. She earned a Bachelor of Science degree in Business Administration. Joan has experience as a Nurse, Administrator, Developer, Trainer, Grant Writer, and served as Administrator of SD State Survey Agency. She has consulted with health care facilities and nonprofit organizations and presented leadership training. Joan is the author of Guidebook for Assisted Living Facilities and Senior Service Providers and Guidebook for Physician Services in the Nursing Facility, and she has published in professional journals.

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