All posts by JUCM

The Journal of Urgent Care Medicine supports the evolution of urgent care medicine by creating content that addresses both the clinical practice of urgent care medicine and the practice management challenges of keeping pace with an ever-changing healthcare marketplace. As the Official Publication of the Urgent Care Association of America and the Urgent Care College of Physicians, JUCM seeks to provide a forum for the exchange of ideas and to expand on the core competencies of urgent care medicine as they apply to physicians, physician assistants, and nurse practitioners.

Posted On July 19, 2017By JUCMIn Payers

E/M Coding Could Be Heading for an Overhaul

The Centers for Medicare and Medicaid Services says providers have been clamoring for an update of the 1995 and 1997 guidelines for evaluation-and-management (E/M) codes—and it may be ready to oblige them. If it goes forward, the plan would take years to implement and focus mainly on revising the history and physical exam portion of a patient encounter. The aim, according to CMS, would be to simplify and better align E/M coding and documentation, presuming that would improve workflow at the practice level—including in urgent care centers. The changes wouldRead More
Hospital-owned urgent care centers—many of which became “hospital-owned” thanks to a relatively generous 50% reimbursement rate for off-campus patient visits—may be taking a substantial hit if the Centers for Medicare and Medicaid Services follows through on a plan to cut that rate by half. Hospital administrators say even though running off-campus clinics increases their operating budgets, they enable health systems to offer more patients access to cost-effective care. On the other hand, the Trump administration predicts cutting the pay rate to 25% could save the system as much as $25Read More
Urgent care operator American Family Care (AFC) has inked an investment deal worth $1 billion with the private equity and real estate firm American Development Partners. The funds will be put to work expanding AFC’s presence around the country, with the expectation that 300 more franchises will open under the AFC banner (currently, there are 170). AFC is quick to note that the company will not change hands, and that it will continue to invest its own resources in developing franchises and wholly owned clinics. American Development Partners’ role willRead More
MinuteClinic has made its name by giving customers shots and offering immediate care for low-acuity infections (ie, those for which prescriptions can be dispensed within the store). Now, however, it has announced a plan to partner with Alere eScreen to provide occupational medicine-type services for employers—most notably, including drug screens. The plan is to contract with companies who will send their workers to the CVS-operated clinics for biometric screenings, vaccinations, and Department of Transportation physicals, in addition to the drug tests. Unspoken in the announcement of the initiative is whetherRead More
  A new patient—a 45-year-old man who says he’s been plagued by midfoot pain for several weeks—presents to your urgent care center. The foot is normal in appearance, but it is evident that the patient has pain palpation over the midfoot. There is no pain with palpation over the plantar aspect. Skin does not show signs of infection. The neurovascular status is intact. View the image taken and consider your next steps, along with possible diagnoses.Read More
Food and Drug Administration Commissioner Scott Gottlieb, MD says his agency needs to do more to help stem the opioid-addiction epidemic in the United Sates. For starters, he wants the FDA to impose stricter guidelines for prescribing immediate-release opioid drugs. The first step will be for the agency to expand training for physicians, nurses, and other providers who administer immediate-release opioids. While there is already training available, the FDA says it will now broaden information it provides about nondrug, not just nonopioid, approaches to pain control. Gottlieb promises the agencyRead More
Think about the last promotional pen you used, or the sticky-pad you wrote on with it. It’s likely you don’t remember where you picked up either of them (even if it was the same place). Now, imagine that you used a tick remover that was given to you to remove a blood-sucking parasite from your child’s arm. You probably know where that one came from. PhysicianOne Urgent Care hit on that very idea when it was looking for a meaningful way to celebrate its 1-year anniversary of treating patients inRead More
Trustees for the actual Medicare trust fund say it will be insolvent by 2029, a year later than predicted by the Obama administration last year. The year before that, the Congressional Budget Office foresaw the program running dry in 2026. This means the infamous Independent Payment Advisory Board—devised by the designers of the Affordable Care Act (ACA, or “Obamacare”) to put the brakes on Medicare spending if costs grew faster than a predetermined rate—will not take effect. The date by which Medicare would go out of business, so to speak,Read More
The U.S. departments of Health and Human Services (HHS) and Justice (DOJ) have announced charges against 412 defendants in the largest healthcare fraud action yet by the Medicare Fraud Strike Force. Among those charged are 115 doctors, nurses, and other licensed medical professionals. More than 120 of the defendants are charged with taking part in prescribing and distributing opioids, as well as other narcotics. All told, the alleged fraud schemes amount to $1.3 billion in falsified billing. Thirty Medicaid Fraud Control Units also participated in today’s arrests. In addition, HHSRead More

Posted On July 12, 2017By JUCMIn Clinical

Drug-Resistance Growing in STDs

Rising rates of antibiotic resistance in general have been discussed extensively. What has not been addressed as specifically is the growing number of cases of antibiotic-resistant gonorrhea and other sexually transmitted diseases. Data that show condom use is declining makes this trend even more alarming, the World Health Organization warns. Neisseria gonorrhoeae, the bacteria that causes the STD, in particular, has become prone to developing resistance to the drugs used to treat it, according to the WHO. “Widespread” resistance to older, relatively inexpensive antibiotics is resulting in cases that areRead More