WELCOME TO NAFEC
The National Association of Freestanding Emergency Centers (NAFEC) is an advocate for freestanding emergency care facilities and the patients they serve. The association represents members in healthcare policy development and promotes freestanding emergency care as an effective option for timely, cost-effective, high-quality healthcare nationwide.
Freestanding Emergency Centers (FECs) are state licensed, full-service emergency departments staffed 24/7 with emergency trained ER physicians and nurses. Although structurally separate from a hospital, FECs offer all the capabilities of a hospital-based ER, including advanced imaging (CT, X-ray, Ultrasound), onsite laboratory and pharmacy. FECs are EMTALA-compliant, meaning they are required to provide medical screening examinations and stabilize all patients with an emergent condition.
In 2009, FECs were a new type of emergency care provider created to improve access to emergency services. As this innovative care delivery model grew, NAFEC was founded to advocate for FECs and their patients. The association has dedicated itself to educating legislators, regulators, and the general public about the unique value FECs bring to the healthcare landscape.
NAFEC has grown to represent all models of freestanding emergency care, including independently operated FECs, specialty emergency hospitals, physician and proprietary owned facilities, and joint venture partnerships between FECs and hospitals. The association promotes ethical business practices in the FEC industry, implementing guidelines to ensure members operate their facilities in a fiscally and socially responsible manner.
By providing an ongoing advocacy presence in Washington, DC, NAFEC represents member perspectives on national legislative and policy issues and provides a unified voice for freestanding emergency care across the country. State chapters of NAFEC also promote and safeguard freestanding emergency care in their respective states.
We are excited to offer membership and sponsorship opportunities throughout the year. Please tell us about your interest at info@nafeconline.org.
NAFEC President, Rob Morris, Explains Freestanding Emergency Centers
Freestanding Emergency Centers: The Journey Towards Medicare Recognition
Summary of Research Reported by Dobson DaVanzo & Associates | July 14, 2025
This research provides critical insights into how federal Medicare recognition of FECs—through H.R. 3134—could impact patient care and the broader healthcare ecosystem over the next decade.
Key Findings:
Projected Medicare Savings:
- $83M–$121M over 10 years with no induced demand (Scenario 1)
- $69M–$100M with a modest 5.1% increase in emergency care utilization (Scenario 2)
- Savings stem from efficient delivery of care and exclusion of facility fees for low-acuity services (Level 1 and 2)
Supplemental Savings:
· $229M from avoided hospital admissions for COPD
· $167M from avoided hospital admissions for CHF
· $46M from avoided hospital admissions for chest pain
· $6M–$9M additional savings if Medicare covers rural FECs only
What This Means for Emergency Care:
· Lower Cost, Same Quality: FECs deliver emergency care at ~25% lower Medicare cost than hospital-affiliated EDs
· No Evidence of Increased Utilization: Data from Texas during the three year Public Health Emergency waiver period showed no increase in emergency visits
· Growth Potential and Improved Access to Emergency Care: Up to 185 FECs could be Medicare-recognized by 2035, especially in states without Certificate of Need (CON) laws