Sunday, March 27, 2016

Dr. Kwon's Excel ER Facility Won't Lower Healthcare Costs


Bulldozers broke ground at the corner of Sherwood Way and Southland Boulevard for Excel ER, a freestanding emergency room.  Excel ER operates 24 hours a day, 365 days a year in four Texas communities.

The Texas Legislature paved the way for freestanding emergency rooms with a bill passed in 2009, however government payors, Medicare and Medicaid, do not reimburse freestanding ER's for care provided.  Excel ER serves people with private health insurance and/or significant personal financial resources.

San Angelo patients will have a learning curve to navigate as they consider the appropriate place to have their crisis healthcare needs met.  Insured patients in San Angelo are used to seeing their primary care doctor or being referred to urgent care, if the wait to see their doctor is too long.  The ER decision, if not directed by their health plan, meant choosing between Shannon Medical Center and San Angelo Community Medical Center.  Area insured citizens will have other options.

In the words of President Christopher Kwon, M.D., Excel ER's value proposition is not lower costs, according to the Tyler Morning Telegraph.  

“Excel ER offers virtually the same rates as traditional hospital-based ERs,” Kwon said. “Urgent care centers do not treat the same level of emergencies as a hospital ER and freestanding ER’s, so their costs would naturally be different.” 
A local businessman said the Excel ER lot was purchased at a significant premium.  His words, "Never before has anyone paid so much for commercial real estate in San Angelo acre for acre."

Wheelhouse Development LLC is behind the commercial real estate side of Excel ER.  Wheelhouse is based in Lubbock and has a one person board, Brady Collier.  Maybe the Wheelhouse Development team knows something grizzled San Angelo businessmen don't.  Time will tell in regard to San Angelo commercial land values.

City of San Angelo Development Corporation documents show a $1.7 million price tag for the Excel ER project.  That price cannot include state of the art digital x-ray, CT scanner, ultrasound and medical laboratory equipment.  Total project costs are certainly a multiple of the $1.7 million amount listed.

Excel ER's value comes from a mixture of time and luxury.  Tyler Morning Telegraph reported:

“The main difference between our new facility and a hospital ER is that our patients are seen by a board-certified emergency doctor within minutes of coming through our doors, while it may take a much longer period of time for that same patient at a hospital ER,” Kwon said.
Kwon said Excel ER patients are seen by an ER doctor in five minutes or less in a television interview.  This compares to 17 minutes for SACMC and 23 minutes for Shannon's Emergency Department, a level 3 trauma center.

Midland Reporter Telegram highlighted:

While most patients spend little time in Excel ER’s lobby/waiting area, it has been designed with a four-star hotel ambience, so a patient’s family will feel more comfortable and at ease during what can be a stressful time.
Katy, Texas based Kwon is the sole board member for Excel ER. He's also listed as one of three board certified ER doctors for Excel's Weatherford site.  Excel partnered with ER physician groups, Leading Edge Medical Associates in East Texas and Code 3 Emergency Physicians in Weatherford.  Kwon also set up North Texas ER I LLC in Weatherford.


It's not clear who Kwon will partner with for emergency physician services in San Angelo.  I can't imagine anyone from Shannon or Community being involved, but I've been surprised before by actions taken by local folk.

Excel ER represents a myriad of corporate entities wanting to siphon patients with health insurance from area hospital emergency departments.  Taking the cream off the top will not decrease health care costs in our community.  It may make a few people, like Brady, Collier, Dr. Kwon and their partners, lots of money.  It's the new wheeling and dealing health care landscape.  In the end it will cost us all more.

Note:  While not the subject of this piece another freestanding ER by Neighbors Emergency Center is also underway.  Development Corporation documents show that project at $1.3 million.

Update 8-21-16:  The Standard Times ran a story on freestanding ER's but failed to mention either of our two new local sites.

Update 10-13-16:  The Standard Times story on Neighbors freestanding ER showed local hospitals playing nice with the new guys in town.  Excel ER is the next to open.

Update 4-2-17:  The Standard Times reported on Wheelhouse's development of other pads near their newly opened Concho Valley ER.  Three new food establishments are coming, Jimmy John's, Firehouse Subs and Bahama Bucks.  The paper kindly ran the phone number for Wheelhouse leasing. That's advertising, not news.

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