Six Key Factors Driving the Growth of Freestanding Emergency Departments

June 24, 2015


Freestanding emergency departments represent a growing trend in the midst of a changing healthcare landscape. Over the last decade, the number of freestanding EDs in rural and suburban areas has rapidly increased. There are now more than 400 stand-alone emergency departments nationwide, and the number of these facilities is quickly growing in some states.

In Alabama, we recently completed the first freestanding ED in the state, the UAB Medical West Emergency Department in Hoover.

The trend started much earlier in North Carolina, where we constructed the first freestanding ED that was not operated on a hospital campus, the WakeMed North Healthplex Emergency Department, in 2004-2005. WakeMed has been one of the leaders driving the boom of hospitals opening stand-alone EDs, and we have constructed two others for this client since 2004.

CHS SouthPark Emergency Department in Charlotte, NC

North Carolina now has a significant number of freestanding EDs, including two we completed in 2014—the Carolinas HealthCare System (CHS) SouthPark ED and the CHS Harrisburg Pavilion—and one we completed in 2015, the New Hanover Regional Medical Center Emergency Department North.

Brasfield & Gorrie Regional Vice President Scott Duckworth has overseen many of these recent construction projects and offered his perspective on the trend. “We’ve seen significant growth in the construction of freestanding emergency departments over the past decade,” Duckworth said. “Our clients are finding that these facilities meet key needs for both patients and their business strategies.”

Several key factors are driving the growth of freestanding EDs:

  1. Reduced crowding – Many hospitals are opening these stand-alone clinics in hopes of reducing crowding within traditional, hospital-based emergency rooms.
  2. Improved access – In rural areas where more and more full-service hospitals are shuttering and patients often have to travel hours to the nearest hospital, freestanding EDs are providing much-needed access to emergency care.
  3. Greater convenience – Freestanding EDs in suburban areas are offering greater convenience for patients, allowing them to access emergency care that is closer to home and easier to navigate.
  4. Growth opportunities – As part of a growth strategy, some hospitals are opening freestanding EDs in the suburbs that feed into their tertiary-care facilities, positioning the satellite locations to become feeders for the major urban medical center.
  5. Billing practices – The similarities between freestanding EDs and traditional EDs extend to billing practices; freestanding EDs bill just like any other emergency room, charging fees that are significantly higher than those charged by urgent care clinics.
  6. Lower cost of construction – While freestanding EDs typically have all of the equipment you would expect to find in a standard emergency room, they are much faster and less expensive to construct than a full-service hospital. In addition, these facilities can be built to allow for future expansion as population growth creates need.

As this trend continues, we expect to see a growing number of freestanding emergency room construction projects and will continue to stay on the forefront of this trend.