Urgent Care Offers a “Better Way” in our Health Care System

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As everyone who has ever gone to an emergency room for less-severe medical care knows, it can be a very “disappointing†experience: long-waits, little “customer-service†and expensive. The movement over the past decade to create Urgent Care-type facilities offers a better way for serving people in need, and is likely to save everyone money.

Julie Creswell noted, in the “Race Is On to Profit From Rise of Urgent Care†(New York Times, July 9, 2014), that many companies are moving into this growing industry. Visiting a care center in Norwalk CT, she notes that people use such medical clinics for services like having blood drained from a bruised finger, care for eye trouble, and having a throat swabbed. Some have limited hour access, like doctor’s offices, while others are open 24/7 like a hospital’s emergency room. The business model is simple: Treat many patients as quickly as possible. Urgent care is a low-margin, high-volume proposition. At PhysicianOne, for instance, most people are in and out in about 30 minutes.

Urgent Care is one of the fastest-growing segments of American health care; once derided as “Doc in a Box†medicine, urgent care has mushroomed into an estimated $14.5 billion business, as investors try to profit from the shifting landscape in health care. Indeed, Private Equity has been leading the charge: since 2008, they have invested $2.3 billion into urgent care clinics. Commercial insurance companies, regional health systems and local hospitals are also looking to buy urgent care practices or form business relationships with them.

Urgent care clinics have a crucial business advantage over traditional hospital emergency rooms in that they can cherry-pick patients. Most centers do not accept Medicaid and turn away the uninsured unless they pay upfront. Hospital E.R.s, by contrast, are legally obligated to treat everyone. The national average clinic charge runs about $155 per patient visit.

Increasingly, they’re not only appearing on street corners and in malls, but also within larger stores such as Walmart, and drug-store chains like CVS and Walgreens. They’re also being acquired by giant insurance companies, like Humana, and hospital systems.

While some fear the quality is going decline because this is being viewed as a money-making machine, they miss the potential for providing more responsive care for less severe medical issues.“We expect to do our banking 24 hours a day, seven days a week, and to shop 24/7,†said Dr. Ateev Mehrotra, an associate professor in the Department of Health Care Policy at Harvard Medical School and an adjunct policy analyst at the RAND Corporation. “So now we want our health care to be 24/7.†Indeed, I once turned around a public health care company offering a service, where people could take one day off from work and get all their dental needs met, including having a new set of teeth created and inserted in the patient, rather than making the traditional 3-5 visits for the same service. And, the overall cost was less expensive.

For instance, the average charge to treat acute bronchitis at an urgent care center in 2012 was $122, compared with $814 at an emergency room, according to CareFirst Blue Cross Blue Shield, which operates in Maryland, Northern Virginia and the District of Columbia. The price of treating a middle-ear infection was $100 versus nearly $500 in an E.R. Such cost differences matter not only to commercial insurers, but also to consumers with high-deductible health plans.

Urgent Care will be a “better way†for such health care, especially if consumers provide ongoing feedback on their experiences in terms of convenience, quality of care, staff-interactions, waiting times, and costs. It’s a perfect opportunity for consumer-feedback to keep it getting better and better over time!