Clinics that put an urgent care center and an emergency room under one roof are leaving some patients with ER-level bills they say they did not expect, STAT reports.
A Texas woman went to a clinic with a urinary tract infection, was diagnosed, received antibiotics and paid a $211 bill. Then a second bill arrived, for $1,756, according to an investigation STAT published on Oct. 30 [1].
The clinic, Methodist Legacy ER & Urgent Care in Allen, Texas, operates as both an emergency room and an urgent care center. STAT reports that it is run by Intuitive Health, a private equity–backed company that operates nearly 50 others like it [1].
Background
Intuitive Health says it opened its first full-service ER and urgent care under one roof in 2008 [2]. The facilities partner with local hospital systems and carry those systems' names [4].
Earlier reporting describes how the model is supposed to work. In a 2024 report on Intuitive's partnership with UF Health in Jacksonville, Florida, KFF Health News reported that doctors decide after a medical screening whether a visit is urgent or emergency care, the health system bills accordingly, and patients are told of that decision at the time of service [3]. In that arrangement, the hospitals handled medical staff and billing, while Intuitive handled administrative functions, including initial payment collection [3]. UF Health also required patients who needed ER-level care to sign a form acknowledging they would be billed for an ER visit [3].
In a 2022 interview with Chief Healthcare Executive, Intuitive CEO Thom Herrmann said more than 70% of patients leave with an urgent care bill. He said patients sign an acknowledgment form explaining why additional tests or services were ordered before those tests are done [4]. These descriptions come from 2022 and 2024 and may not reflect every facility's current practice.
What STAT Found
According to STAT, the patient, Kristin Gills, tried calling about the second bill and sent three messages through MyChart without a reply [1]. She then posted a negative Google review and a note in a local Facebook group [1]. A Methodist representative eventually contacted her and offered a cash-pay discount that cut her balance to $667 [1]. She is not paying it. "This will be the hill I die on," she told STAT [1].
The antibiotics were the easy part.
Gills is not the only one. Other patients told STAT they went to these clinics for coughs, congestion and flu symptoms and were billed for ER care, often thousands of dollars [1]. The publicly available part of STAT's report does not say whether Gills was asked to sign an acknowledgment form. The full investigation is for STAT+ subscribers; this article relies only on the portion STAT has made public.
The Company's Response and the Rules
Intuitive Health told STAT that the hybrid facilities are good for patients because they spare them from having to guess whether their condition is an emergency [1]. On its website, the company lists "only billing patients for the level of service provided" as a major part of its commitment [2]. In 2022, Herrmann said, "There's never a surprise on the backend" when a patient receives an emergency-level bill [4].
Outside experts have been divided on the model. In KFF Health News's 2024 report, consumer advocates said they worried hospitals were more likely to route patients to costlier ER-level care whenever possible. Patient advocate Cynthia Fisher said federal surprise-billing protections do not extend to urgent care centers [3]. Health economist Vivian Ho put it more bluntly: "Patients are at the mercy of what the hospital tells them" [3]. A Texas A&M researcher in the same report called the model potentially good for patients [3].
Texas has passed laws aimed at freestanding ERs. In 2019, lawmakers approved HB 2041, which requires a printed disclosure in English and Spanish listing in-network plans and the average price a patient may be charged, including facility fees [5]. They also approved HB 1941, which lets the state attorney general act against "unconscionable" rates, defined as 200% above the average hospital charge for similar treatment [5]. The Texas Tribune's account of those laws does not address hybrid facilities, and VBN could not determine from public sources how the laws apply to clinics like the one in Allen.
What Comes Next
The public portion of STAT's investigation does not name any regulator looking into the clinics [1]. Intuitive's footprint has grown: in 2022, Herrmann said the company had 16 hybrid locations and more than 50 others in development [4]. STAT now describes nearly 50 facilities like the one in Allen [1]. The full STAT+ report may add detail on billing practices and company responses that VBN has not been able to review.
This article is for informational purposes only and is not medical, legal or financial advice. Readers should consult their clinician with questions about their care.
References
Bannow T. "How a simple UTI turns into a $1,756 bill." STAT. Oct. 30, 2026. https://www.statnews.com/2026/10/30/hybrid-er-urgent-care-clinics-hidden-billing-complaints-intuitive-health/
Intuitive Health. "Legacy ER & Urgent Care" (partner page). Accessed Oct. 31, 2026. https://www.iheruc.com/our-partners/texas/legacy-er-urgent-care/
Galewitz P. "Urgent Care or ER? With 'One-Stop Shop,' Hospitals Offer Both Under Same Roof." KFF Health News. Aug. 2, 2024. https://kffhealthnews.org/health-industry/urgent-emergency-care-combo-centers-intuitive-health-jacksonville-florida/
Southwick R. "How Intuitive Health is combining urgent care and emergency care." Chief Healthcare Executive. Apr. 27, 2022. https://www.chiefhealthcareexecutive.com/view/how-intuitive-health-is-combining-urgent-care-and-emergency-care
Byrne E. "Texas has more than 200 freestanding ERs. Lawmakers just passed bills to combat patient confusion and price gouging." The Texas Tribune. June 3, 2019. https://www.texastribune.org/2019/06/03/freestanding-emergency-centers-bills-legislature/
