KAISER PERMANENTE: HMO Will Increase ER Visit Fee
Beginning in January, Kaiser Permanente will raise its fee for emergency room visits from a $5 co-pay to a $35 co-pay -- a sevenfold increase -- the Contra Costa Times reports. Retirees' costs for emergency room visits will increase too, from between $5 and $7 to $20. Kaiser officials said that the price hikes are aimed at herding patients away from costly emergency rooms and into less costly urgent-care clinics for less serious medical needs. But critics assert that the change may prevent low-income patients from receiving critical care in times of need due to financial considerations. California Nurses Association Executive Director Rose Ann DeMoro said some patients "will be deciding between groceries and health care when they're sick and feeling their most vulnerable." She added that it was a particularly poor time to raise prices, as the winter flu season begins and emergency rooms are at their busiest. "People are getting less care and paying more for it. They've instituted all these gatekeeping practices that are designed to frustrate people trying to use the system," she said. But Kaiser Permanente officials counter by explaining that employers requested the change as a long-term strategy to help keep premiums low. Moreover, Kaiser Permanente will waive the $35 fee if the patient is formally admitted to a hospital. Company representatives also referred to an internal study from 1996, which revealed that the 30,000 members whose benefits required a higher ER co-pay than other Kaiser Permanente packages used the ER 15% less. In addition, the higher cost did not decrease emergency room visits by patients requiring urgent care, the study noted. Kaiser Permanente spokesperson Lila Petersen said, "If members use urgent care instead of the ER (for non-emergencies), that's better for them and it's better for us, because their health costs will be kept down." Kaiser Permanente currently serves about 6 million members in the state, making it California's largest HMO (McMillan, 12/22).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.