Journal of Urgent Care Medicine

Triage Systems Work Well To Direct Patients to UC Rather Than ED

A narrative review of literature exploring patient triage found that structured, evidence-based systems that differentiate between emergency departments (EDs), urgent care (UC), and primary care can be useful in scaling down the inappropriate use of EDs. Published in Cureus, the editorial concluded that the specificity of triage systems in terms of identifying true ED cases ranges from 85-95%. Additionally, the author found several features of UC visits that were superior to comparable ED metrics. Urgent …

U.S. Healthcare Spending Climbs Past $5T Mark

The United States now spends $15,474 per person on healthcare for a total of $5.3 trillion in spending overall in 2024, according new federal data reported by Health Affairs. For 2 years in a row, health spending increases have topped 7% (7.4% in 2023; 7.2% in 2024). Increased demand for care and higher intensity of services are the main drivers of growth, according to the analysis. Year Total Expenditures (trillions) Expenditures Per Capita 2018 $3.6 …

Banner Health Shifts to All Cashless Payment

This month, Banner Health is moving to a cashless payment system as a cost-savings measure, according to a press release. The nonprofit system has rolled out the cashless model across Arizona and will phase in the policy across other locations (California, Colorado, Nebraska, Nevada, and Wyoming ) in the coming months with a target date to complete the transition by March 2026. Cash collection creates administrative costs that represent more than a third of the …

Accurate AI Coding Boosted Reimbursement Among Highmark Providers

Highmark Health is finding that artificial intelligence (AI) can influence reimbursement, according to Modern Healthcare. The integrated system’s insurance unit posted an operating loss that was tied to higher utilization as well as an increase in coding accuracy coming from providers in their claim submissions. Thanks to AI, providers are more likely to submit cleaner claims that better reflect the reality of clinical care and patient acuity—which also may incur higher reimbursement. It’s not fraud, …

Access to Care in New Jersey Shrinks As Specialists Scale Back

Optum—the large subsidiary of UnitedHealthcare that delivers clinical care and employs physicians and other providers—is scaling back some of its specialty services and locations in New Jersey, according to local outlet NJ.com. Letters notified patients that about 90 locations in the state would shutter in December, reducing its offerings in several areas, such as behavioral health, dermatology, and orthopedics. However, a spokesperson told Patch providers would continue to offer pediatric, primary care, cardiology, rheumatology, and …

Execs Rely on AI, Predict New Investment in On-Demand Care Options

Healthcare executives meeting at the J.P. Morgan Healthcare Advisory Council in New York recently highlighted how rapidly the health sector is shifting under technological, financial, and policy pressures. In terms of technology, artificial intelligence (AI) is now delivering real-world operational benefits, including shorter hospital stays, faster workflow automation, and reduced administrative burdens associated with clinician documentation, they said at the meeting. Leaders also noted that organizations need to sketch out scenario-based plans because major Medicaid …

New Antiviral Flu Biologic Attracts Merck To Cidara Deal

Merck recently announced its intent to acquire Cidara Therapeutics in a deal with a total transaction value of approximately $9.2 billion. Cidara’s pipeline includes an experimental long-acting antiviral drug that has the potential to offer single-dose, universal prevention against influenza A and B. Known as “CD388,” the pipeline product is not a vaccine but a low molecular weight biologic. It is expected to offer seasonal protection for various populations, including immunocompromised individuals. The transaction is …

CMS May Refine Place of Service Code For Urgent Care

The Urgent Care Association (UCA) continues to seek differentiation for urgent care in the place of service (POS) definitions used by the Centers for Medicare and Medicaid Services (CMS) to construct payment schedules, which are updated yearly. In the 2026 Medicare Physician Fee Schedule, UCA’s advocacy efforts were noted in the Federal Register document with a statement indicating comments offered about the POS for urgent care will be taken into consideration by CMS for possible …

What It Costs To Chase Payment

A recent MedCity News survey reveals that providers end up investing about 2-10% of the collection value of their claims on subsequent efforts to chase down payment, scrubbing away at margins and slowing administrative workflows in revenue cycle management. At the same time, 90% of hospital and physician practice respondents say they are at least somewhat interested in artificial intelligence tech tools to make improvements in billing, and about 66% already have experience with such …

Patients, Telehealth Providers Stretch Weight Loss Drugs With Microdosing

Trends show that some patients are choosing to microdose their glucagon-like peptide 1 receptor agonists (GLP-1RA) prescriptions for diabetes and weight loss, whether a provider advises it or not. It’s believed that microdosing can be helpful to quell significant gastrointestinal side effects or to titrate scheduled dosing with individualized provider recommendations, however, microdosing is still considered unconventional, according to the American Diabetes Association (ADA). For example, each semaglutide multidose pen delivers about 72 unnumbered “clicks” …

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