Strengthening Emergency Care with Freestanding Emergency Departments

January 15, 2025

Managing Director, Management Consulting

Freestanding Emergency Departments (FSEDs) are transforming the landscape of emergency care.

As traditional hospital-based EDs grapple with overcrowding, rising costs, and the ever-growing demand for services, FSEDs have emerged as a forward-thinking solution. These facilities bring care closer to patients, streamline operations, and allow healthcare systems to enhance their presence in the market.

But building a successful FSED is no simple task. It requires a strategic vision informed by market insights, operational expertise, and alignment with broader organizational goals. By addressing critical challenges and capitalizing on key opportunities, healthcare organizations can position FSEDs as essential components of their care delivery model.

Why Freestanding Emergency Departments Matter

Over the past several decades, the healthcare landscape has shifted dramatically. Between 1995 and 2018, the number of hospital emergency departments declined from 4,923 to 4,577, even as patient volumes surged. This imbalance has left many communities underserved, with nearly 20% of Americans living more than 10 miles from the nearest hospital. FSEDs are bridging this gap, offering accessible, efficient, and patient-centered emergency care closer to where people live and work.

Beyond improving access, FSEDs alleviate pressure on overcrowded hospital EDs. By catering primarily to lower-acuity cases — with only 6–10% of FSED patients requiring hospital admission compared to 20% at traditional EDs — these facilities streamline care delivery and free critical resources for higher-acuity cases.

FSEDs also represent a cost-effective expansion strategy. Requiring significantly lower capital investment than full-service hospitals, they offer healthcare systems a scalable solution for geographic growth. Programs like the 340B Drug Pricing Program and innovative staffing models further enhance their financial viability, making FSEDs a smart investment for the future.

Key Considerations for Developing a FSED

Creating a successful FSED involves careful planning and thoughtful design. Each step must be aligned with the unique needs of the community and the strategic goals of the healthcare system.

Market Analysis

Understanding the local population’s needs is the foundation of a successful FSED. Evaluating demographic trends, emergency care demands, and competitive dynamics ensures the facility is positioned to address service gaps and strengthen geographic coverage.

Regulatory & Operational Factors

State regulations significantly influence FSED structures and reimbursement models. Additionally, integrating scalable services such as primary or urgent care can optimize resource utilization and ensure compliance with regulatory standards.

Design & Workflow Optimization

Lean design principles are essential for creating efficient, patient-centered spaces. Advanced imaging capabilities, fast-track systems for low-acuity patients, and telemedicine options can further enhance workflow and satisfaction.

Community Integration

FSEDs must not only serve as healthcare access points but also as trusted hubs within their communities. Tailoring the facility to address local cultural and healthcare needs fosters stronger connections and long-term success.

How ERDMAN Can Help

At ERDMAN, we specialize in guiding healthcare organizations through the complexities of FSED planning and implementation. From conducting market assessments to designing high-performance facilities, our approach is tailored to meet your unique needs and strategic vision.

We Provide:

Strategic Insights: In-depth market analysis to evaluate feasibility and opportunities.
Design Excellence: Facilities designed for seamless workflows and exceptional patient experiences.
Operational Efficiency: Expertise in Lean principles to optimize resources and processes.
Comprehensive Support: End-to-end assistance, from concept to deployment.

Jim Medendorp

Managing Director, Management Consulting

Take the Next Step

Freestanding Emergency Departments offer a vital opportunity to expand access, enhance efficiency, and strengthen your healthcare system’s market presence. With the right planning and execution, they can redefine emergency care delivery.

Contact ERDMAN today to learn how our expertise can help you develop a successful FSED that meets the needs of your community and supports your organization’s goals for sustainable growth.

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July 9, 2026

Strengthening Emergency Care with Freestanding Emergency Departments

Freestanding Emergency Departments (FSEDs) are transforming the landscape of emergency care.

Why Freestanding Emergency Departments Matter