As of June 1, all patients who visit the emergency room will be evaluated to determine whether they have a truly emergency condition. If the patient has a minor condition that doesn’t require emergency treatment, they can either go to a primary care facility or stay in the ER and get treated, but pay up front.

Uninsured patients must pay a $150 deposit; insured patients must pay their co-pay or co-insurance.

All patients who have true emergencies will continue to be treated without regard to ability to pay.

Jim Gardner, president of Northeast Georgia Health System, said the new policy is necessary because the hospital’s ER treats 100,000 patients a year, and one-third of those are nonemergency.

"This is about encouraging personal responsibility and accountability," he said Wednesday.

Many metro Atlanta hospitals have already adopted this type of ER payment policy to persuade patients to seek care in the most appropriate setting.

Low-income patients in Gainesville have several primary care options, including Good News Clinics, Medlink Gainesville and the Hall County Health Department. Insured patients may choose to go to Quick Care or other walk-in clinics, all of which are far less expensive than getting treated in the ER.

In April, Northeast Georgia Medical Center changed its payment policy for elective procedures, such as CT scans and nonemergency surgeries. Uninsured patients must pay 25 percent of their cost up front, or $500, whichever is less. Low-income patients can apply for a charity discount.

Gardner said the new payment structure for elective procedures seems to be working well. But it remains to be seen whether ER patients will be as accepting of the change in policy.

"I think the potential for negative feedback (in the ER) is higher," he said.