Journal of Urgent Care Medicine

MedPAC Wants to Cut Reimbursements to Off-Campus, 24-Hour Hospital EDs

Medicare reimbursements to many freestanding emergency rooms will be cut significantly if a new recommendation by the Medicare Payment Advisory Committee (MedPAC) is implemented. MedPAC voted unanimously to reduce reimbursements to off-campus, 24-hour hospital EDs located in urban areas within 6 miles of an on-campus ED by 30%. According to an Erdman analysis of the proposal, freestanding, off-campus EDs typically have lower operating costs than on-campus EDs but receive the same Medicare payments—giving them higher …

Article Highlights Migration from Traditional Primary Care to Urgent Care

The ongoing growth of urgent care, among other trends, is at least partially responsible for an increasing scarcity of traditional primary care physicians, according to analysis of new data posted to Advisory Board. Citing research by the Health Care Cost Institute and an article just published in The New York Times, the piece notes that “the emergence of urgent care centers and retail clinics, as well as proliferating mergers between healthcare providers” is lowering patients’ …

California Takes Sutter Health to Court Over Healthcare Costs

Sutter Health, which counts 32 urgent care clinics, 24 hospitals, and 35 surgery centers among its vast holdings, is the target of a lawsuit from the California attorney general, charging that it engages in anticompetitive practices that drive up prices for consumers and insurers. The suit is also viewed as an indictment of industry consolidation, which is resulting in fewer entities and less competition. While it has declined to comment on the suit specifically, Sutter …

NY Times Cites Links Among Mega Mergers, Shrinking PCP Market, Growth of Urgent Care

Regular readers of JUCM News know mergers between large corporations in previously disparate markets (eg, insurance and provision of healthcare) have been coming fast and furious. Simultaneously, fewer newly minted physicians are choosing primary care as their practice of choice as on-demand healthcare continues to grow. None of these trends occurs in a vacuum, of course—in fact, it’s likely that there are directly links among them, as pointed out in an article just published in …

NP Ranks Continue to Swell in Urgent Care—and Beyond

The number of nurse practitioners currently licensed to practice in the U.S. has more than doubled since 2007, with urgent care continuing to be a source of growth. Of the 248,000 NPs now practicing around the country, 5.9% (14,632) are caring for patients in urgent care centers, according to just-released data from the American Association of Nurse Practitioners. AANP President Joyce Knestrick, PhD, APRN, DFNP, FAANP points to the growing shortage of physicians as evidence …

Urgent Care Claims Up 1,725% Between 2007 and 2016 (and No, That’s Not a Typo)

Insurance claims for urgent care visits grew by 1,725% between 2007 and 2016—more than seven times the growth rate of claims for emergency room visits, according to new data from FAIR Health. The FH Medical Price Index and FH Healthcare Indicators reports also reveal that the median price for an urgent care visit is lower than the cost of new-patient visits to office-based physicians ($242 vs $294, respectively). Fair Health based its data on over …

Patients Value Short Wait Times—a Major Selling Point for Urgent Care

The average wait times to see a physician across multiple settings dropped 5 minutes in 2017, compared with 2016, but patients continue to confirm that comparatively longer wait times most often equate to lower satisfaction with their overall experience. Given that convenience is one key attribute of urgent care, this offers insight into the ongoing growth of the industry. The most recent data from the Medical Group Management Association reveal that the average wait time …

Lines Between Market Segments Continue to Blur as Cigna Plans to Buy Express Scripts

It’s too late to be truly unprecedented, but Cigna’s announcement that it plans to buy Express Scripts, the largest pharmacy benefit management company in the U.S., signals that lines between “traditional” segments of the healthcare industry will continue to be breached for the foreseeable future. Once the deal is done, the combined company will reside in Cigna’s Connecticut headquarters, headed by Cigna CEO David Cordani. The Express Scripts unit will still be based in St. …

New England May Be Headed Toward More Regulation of Urgent Care Industry

Vermont is looking at changing how it classifies urgent care centers, with an eye toward forcing operators to file a certificate of need (CON) before starting construction projects. Right now, independent Vermont urgent care centers are viewed as physician offices, which are exempt from filing a CON. The state’s Office of the Health Care Advocate says it would be more correct to view them as “medical facilities,” which would trigger the need for them to …

Apple Plans to Open Onsite Employee Health Clinics

Perhaps inspired by plans other major employers have to launch their own healthcare entities for employees, Apple will roll out onsite health clinics for its workers this spring as it scales back dependence on outside providers. Rather than making a formal announcement, however, Apple launched a new website for AC Wellness—recognizing correctly that business media would take notice. The site describes AC Wellness as “an independent medical practice dedicated to delivering compassionate, effective healthcare to …

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