Ashley Blachford, Author at Journal of Urgent Care Medicine

A 16-Year-Old Male With Rash to Legs, Altered Mental Status and Fever

A 16-year-old male presents to urgent care accompanied by his father due to acute onset of fever, abdominal pain, fatigue, altered mental status, and a lower-extremity rash. Symptoms began earlier the same day. The patient denies recent upper respiratory symptoms, medication use, travel, or trauma. On physical examination, he appears acutely ill and febrile to 103.1°F (39.5°C). Neurologic assessment reveals altered mental status. Dermatologic exam shows retiform, violaceous purpuric plaques with maroon borders on both …

LLMs Save Time For ED Discharge Notes

When using a large language model (LLM) assistant for generating emergency department (ED) discharge notes at an academic 2,400-bed tertiary hospital in South Korea, physicians gained some worthwhile efficiencies, according to a comparative effectiveness study published in JAMA Network Open. Six emergency physicians created 300 manual notes, 300 LLM drafts, and 300 LLM-assisted notes from 50 patient cases, which were judged on a Likert scale ranging from 1 to 5. Compared with manual documentation, LLM-assisted …

Cost-Of-Care Pressure Leads To Oak Street Clinic Closures

CVS Health plans to close 16 Oak Street Health centers, representing about 7% of its total portfolio of these senior-focused primary care clinics. Doors will shutter by the end of February, and CVS cites rising medical costs as the main reason driving the reduction, according to Forbes. The company did not specify which locations will close but said it will continue to operate 230 Oak Street clinics across 27 states. Increased costs to deliver care …

Training Our Teams to Meet the Needs of Our Patients

Countless times over the last year I have heard variations on a “we can’t” theme. It’s a specific and focused “we can’t” related to the services we are not able to provide to our urgent care patients. “We can’t do that test.” “We can’t use that medication in clinic.” “We can’t have our medical assistants do that.” Sadly, it is purely a reflection of education and training. However, as opposed to responding with increased training …

One Voice, One Vision

In last month’s column, I wrote about the importance of proving Urgent Care’s value—not just in terms of access and convenience, but also in demonstrating the quality outcomes and systemwide impact that make our care essential to patients, payers, employers, and policymakers alike. Over the past several weeks, I’ve had the privilege of hearing from many of you who share this same commitment and are eager to help strengthen Urgent Care’s position in the healthcare …

New Drug Relieves Hot Flashes In Menopausal Women

The Food and Drug Administration has approved the oral drug elinzanetant for the treatment of moderate to severe hot flashes due to menopause. It’s a novel nonhormonal drug with dual neurokinin-targeted therapy (NK1 and NK3 receptor antagonist), according to the manufacturer’s press release. Elinzanetant offers another option for patients, in addition to 2 other nonhormonal therapies: NK3 receptor antagonist fezolinetant; and the antidepressant paroxetine. Two phase III trials with a total of 796 menopausal women …

Fewer Kids Received Antivirals For Flu During Pandemic Years

In a cross-sectional study of 3,378 influenza-positive children across 7 U.S. pediatric hospitals, researchers found a substantial decline in antiviral prescribing in the emergency department during the COVID-19 pandemic, as published in JAMA Network Open. Among 2,514 children at higher risk of severe influenza, 32.2% received antivirals in the prepandemic era (December 1, 2016, to March 31, 2020), compared with 15.6% during late pandemic era (July 1, 2021, to June 30, 2023)—a 53% relative decrease. …

Insurers Automatically Reduce Pay For Some E/M Codes

Several large health insurers are drawing provider backlash for relatively new payment policies that reduce certain reimbursements. Cigna is automatically downcoding 6 evaluation and management (E/M) billing codes (99204- 99205, 99214-99215, 99244-99245) for a small percentage of providers starting this month, for example, resulting in lower payments for some routine office visits. The insurers are leveraging algorithms and claims data to automatically downgrade the codes—often relying on third party vendors to do the adjustments. According …

Get Serious About Credentialing To Avoid New Penalties

Starting January 1, 2026, Elevance Health will consider “corrective measures” that penalize healthcare facilities in 11 states for using out-of-network providers to deliver care for the large insurer’s Anthem Blue Cross Blue Shield commercial health plan members. Health systems may be subject to an administrative penalty of 10% of the allowed claim amount and potential network termination, and the penalty cost cannot be passed on to the patient, according to an Anthem memo. Emergency care …

Severe Mpox Strain Spreads In California

The California Department of Public Health has issued a warning that clade I mpox may be spreading in the state, “primarily impacting communities of gay and bisexual men,” after 3 cases of this rare, more severe strain of mpox were confirmed. At least 1 case occurred in a person with no recent travel who was recently hospitalized and has been discharged to recover at home, indicating that person-to-person community spread of clade I mpox is …

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