Avard: The Limitations Of Freestanding Emergency Rooms

By Kevin Avard, NH Journal

Last year, I suffered a sudden heart attack, the kind of moment that changed my life in an instant. I was lucky. I live in Nashua, where two major hospital systems serve our community, so emergency doctors and nurses were close to my home. I received treatment that saved my life, and I am here today because of it.

This year, I am proud to support legislation designed to ensure that patients in emergency situations such as mine receive the best local care possible.

At its heart, the pending legislation on freestanding emergency rooms is about one thing: patient choice. If you or someone you love faces a medical emergency, you expect to be taken to a nearby hospital that can treat you immediately and admit you if necessary. But not every emergency facility is the same. Freestanding emergency rooms provide emergency care but are not attached to a full-service hospital and cannot admit patients overnight, perform surgery, or provide inpatient care for serious events such as heart attacks or strokes. They bill at emergency department rates and often resemble walk-in or urgent care clinics, which can make it hard to understand the level of care you will receive or the cost involved. That confusion can lead to higher out-of-pocket expenses.

This legislation works alongside existing state and federal laws to ensure you – the patient – have the choice to be transferred to a hospital based on your medical needs and your preferences.

If you enter a freestanding emergency room and need to be admitted, you should receive clear information about your options. You should be told which hospitals are available and closest to your home, and not steered elsewhere because of a business relationship.

Across parts of our state, we are seeing new freestanding emergency rooms built in communities that already have more than one full-service hospital. At the same time, the same company is cutting services at its main hospital while opening additional freestanding emergency rooms. That does not strengthen our state’s healthcare system. If the real goal is expanding access to care, this business should focus on rural and underserved areas of our state, where healthcare options are limited, rather than on cities that already have a significant hospital presence.

None of this is to suggest that freestanding emergency rooms on their own are a problem. More care and more options are positive for our state. In fact, I think that freestanding emergency rooms should be integrated into our local health care system. I support competition, I support patient choice, and I always have. Competition improves quality and expands access. We all know healthcare is facing real challenges, including workforce shortages and rising costs. Competition must serve patients first. It should strengthen the care you receive across our state, not weaken it.

The greater Nashua region is not the only part of our state where we are seeing this new model emerge. Similar freestanding emergency rooms are already operating in other parts of the state, and more are being built. That is why, as legislators, we need clear, consistent guardrails to ensure you have the choice to go to a hospital based on medical judgment, safety, and proximity to your home, not corporate strategy or greed.

In a medical emergency, every minute matters. I am living proof of that.

This legislation is about balance. It strengthens local emergency care and promotes transparency, so you understand your options and the cost of care. It respects federal law. And it protects your rights as a Granite Stater to receive care at the hospital that best meets your needs.

For me, this is personal. For New Hampshire, it is essential.

State Sen. Kevin Avard is the Senate Majority Deputy Whip and represents District 12. He wrote this for NHJournal.com.

This story was originally published by the NH Journal, an online news publication dedicated to providing fair, unbiased reporting on, and analysis of, political news of interest to New Hampshire. For more stories from the NH Journal, visit NHJournal.com.