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EMERGENCIES
Patients choose from
PROLIFERATING FREE-STANDING EMERGENCY CENTERS
URGENT-CARE CENTERS • HOSPITAL EDS
By Robert Frolichstein, MD
There has been significant growth in the number of free-stand- may charge facility fees, such as room costs, surgical trays, supplies,
ing emergency centers in the greater San Antonio area. The reason etc. They may own equipment and subsequently charge for tests
for this growth is as varied as the structures and ownership of the that can be done onsite for patients at time of service. Additionally,
centers themselves. they may charge a “technical” component for the use of diagnostic
equipment, such as X-rays, CT and MRI scanners. Unlicensed ur-
The main impetus to invest in the establishment of a free-stand- gent-care centers may not charge facility and equipment fees.
ing center is much dependent and driven by the ownership model.
For example, a hospital-owned facility might be interested in stak- TEXAS LAW CHANGED
ing out physical territory to protect or enhance its market share. Free-standing emergency centers are more numerous in the state
Also, a hospital might locate a new center to facilitate referrals to
its traditional sites with beds and procedure rooms to increase oc- of Texas than in many other states due to differences in licensing
cupancy or volume of charges. On the other hand, a non-hospi- requirements. In 2010, Texas Administrative Code 25 established
tal-owned facility could be established for purely financial rules and licensing requirements for free-standing emergency cen-
investment considerations. ters. The requirements seem to be less stringent than for other
states. Consequently, hospitals and entrepreneurs have seized the
Licensed free-standing emergency centers in the state of Texas
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