The popularity of urgent care facilities and freestanding emergency rooms may be on the rise in the Greater Houston area, but health care consumers are still confused by their differences and what benefits each provides.

"The main difference is freestanding ERs have more equipment, [such as] MRI and CT," Katy Urgent Care President Tom Gee said. "They should really only be treating emergencies or if they're dying, but people don't know the difference, so they come to urgent care clinics."

Gee said his urgent care center—opened in 2005—can treat everything from the sniffles to broken bones, with colds and the flu the most common ailments of patients. The clinic can perform some lab testing, such as flu tests, but it cannot perform blood tests, he said.

Although Gee said the staff is capable of diagnosing and treating basic urgent care ailments, Katy Urgent Care has only one certified emergency room physician on staff. The rest of the 20-plus staff are physicians assistants or nurse practitioners, he said. Patients who show a shortness of breath, chest pain, abdominal pain or head pain are stabilized while staff call 9-1-1 for a transport to a nearby emergency room.

"If someone comes in with concern of actually dying, we have to transfer them to an ER," Gee said.

There are some advantages to an urgent care clinic, Gee said, including shorter wait times as a result of fewer patients at urgent care clinics. Patients also could pay as little as one-fifth the cost of an emergency room visit for the treatment of the same condition, as emergency rooms have higher rates and require a higher copay, Gee said.

Randy Reid, CFO for Memorial Hermann The Woodlands, compared urgent care centers to a physician's office with extended hours for walk-in availability. Reid said ERs are admittedly more expensive than urgent care centers, but ERs can treat a much wider array of conditions.

"I'd say it depends on the patient and their sense of evaluating their own emergency," he said. "They're the ones that have to determine how life-threatening their condition is."

Health care consumers in The Woodlands have two Memorial Hermann emergency room options: the hospital location and the freestanding ER. Reid said the 11,500-square-foot, freestanding location offers much of the same technology as the hospital emergency room, but there are a few subtle differences.

The freestanding location provides a CT, ultrasound and X-rays and it is staffed by the same on-call doctors who treat at the hospital emergency room, Reid said. However, the facility does not have an MRI machine or inpatient beds to care for patients over an extended period of time. Patients must be treated and sent by ambulance to the hospital to recover.

Reid said the freestanding location is more efficient, as the imaging technology is dedicated solely to the ER. There is no competition for inpatient services and there are fewer patients suffering from severe trauma, he said. The hospital's emergency room sees about 106-107 patients a day compared to only 37 on average at the free-standing site.

Mark Feanny, ER physician and CEO of America's ER in Magnolia, said he believes freestanding emergency rooms are on the rise because they are lucrative for health care providers, are usually located around wealthier communities than hospitals and are not currently recognized by Medicare or Medicaid coverage.

"Uninsured and underinsured people over-utilize hospital ERs because they know [hospital ERs] have to treat them," Feanny said. "That's why hospital ERs get overrun."

Feanny also attributed the growth in these facilities to the increased demand for health care because of the Affordable Care Act and the decreasing number of general practitioners nationwide, which he said will be reduced by one-third by 2025.

Acknowledging the differences and advantages of both urgent care centers and freestanding ERs, Feanny said America's ER plans to offer a hybrid model when the first location opens in Magnolia in January. The 7,100-square-foot facility will allow patients to enter and receive either urgent care treatment or emergency room treatment depending on the patient's condition. He said patients will pay based on the condition.

"Our biggest goal is to provide appropriate health care at an appropriate cost," Feanny said. "If you have a cough and a cold, your cost is going to be billed like a cough and a cold."