Journal of Urgent Care Medicine

Advantage, Urgent Care? Plans Are Already Passing ACA Losses Off on Members

Urgent care operators may have new leverage when negotiating reimbursements or appealing to cash-paying patients in North Carolina. Blue Cross and Blue Shield of North Carolina (BCBSNC) says it has lost $280 million by covering residents under the Affordable Care Act (ACA, or “Obamacare”)—and in response, it’s filing for a 2017 rate increase of 18.8%. BCBSNC says higher-than-expected ED visits and orthopedic treatments (the cost of which could be greatly diminished if appropriate patients visited …

Another Urgent Care Center Makes House Calls New Again

Whether due to transportation issues, childcare needs, or concern about being exposed to others’ germs when they’re already not feeling well, some patients find “convenient care” not quite convenient enough. Remedy, an urgent care company in Austin, TX is one of a number of providers looking to fulfill their urgent care needs by leveraging the advantages of electronic communication to offer an old-fashioned convenience (namely, house calls). Designed to take convenient care to the next …

With Less Competition, ACA Insurers Plan Major Price Increases

With many health insurers already scaling back—or vacating—state exchanges under the Affordable Care Act (ACA, or “Obamacare”), companies that plan on continuing to offer coverage may start charging members more for the “privilege” of being insured soon. Insurance industry projections show that many states could see jumps of 20% or so, while plan members in Pennsylvania and Georgia could see premiums go up by more than a third next year. Initially, 23 health insurance co-ops …

Too Many Kids Head to Primary Care, Not Urgent Care, with Suspected Concussions

New data published in JAMA Pediatrics indicate that far too many children suspected of having a concussion are evaluated first in a primary care office. Between 2010 and 2014, 81.9% of young patients ultimately seen at Children’s Hospital of Philadelphia (CHOP) had their first concussion-related healthcare visit in the primary care setting. Urgent care was a nonfactor, as the remainder sought care first in the emergency room (not surprising, given that the data set was …

Freestanding ER Sticker Shock Still an Issue Despite Transparency Laws

Urgent care operators who face competition from freestanding emergency rooms should emphasize cost differences compared with urgent care, and remind patients that vigilance may be needed to tell the difference between the two. Patients in Texas, for example, are finding that a new law requiring freestanding emergency rooms to post notices that fees may be comparable to a hospital emergency room doesn’t go far enough in preventing surprisingly big bills postcare. One problem: The nature …

Could Tax Dollars Be an Option in Funding a New Urgent Care Center?

If you’re looking to build a new urgent care facility, the first question you’re likely to ask is: How are we going to pay for this? Regional Medical Center (RMC) in Orangeburg, SC is looking to its surrounding community for help by way of using tax dollars to construct a new urgent care center. Brenda Williams, RMC’s vice president of strategy and development, says the emergency room is packed with people seeking nonemergent care. RMC …

Urgent Care Operators Look to Telehealth to See More Patients

Six months after it started offering video visits through Doctor on Demand and American Well, UnitedHealthcare says it expects to “see” 20 million patients that way by the end of 2016. More than half of the visits, to date, have been for respiratory issues. Statistically, the average user is a 31-year-old female. UnitedHealthcare says the vast majority of employers it covers like the idea, but have concerns about how many of their workers will actually …

Fewer Americans Are Uninsured—But Is ACA a Success?

The percentage of uninsured Americans dropped below 10% by the end of 2015, compared with 16% when the Affordable Care Act (ACA, or “Obamacare”) was enacted in 2010. While the Obama administration chalks that up as a “win,” ACA critics question whether patients covered under ACA-supported plans have adequate coverage. Further, insurers have complained that offering coverage through ACA’s state exchanges is not cost-effective, with UnitedHealth and Humana deciding to stop participating in many states. …

PCPs Starting to See the Advantages of Urgent Care

More primary care physicians understand urgent care’s rightful place in the continuum of care—and the advantages it might offer traditional office-based practices, according to a new article in Medical Economics magazine (How Urgent Care Relates to Physicians’ Practices, http://medicaleconomics.modernmedicine.com/medical-economics/news/how-urgent-care-relates-physicians-practices). David Meyers, MD, chief medical officer for the Agency for Healthcare Research and Quality, reflects that “urgent care centers help put resources in the right places” by providing immediate care to those who need it at …

Urgent Care Survey: Baby Boomers Want Quality; Millennials Consider Cost More

Most Americans understand their healthcare options, but diverse age groups value different attributes when deciding where to get that care, according to a new survey by the Urgent Care Association of America. Quality factors, such as having a physician on site (a prevalent urgent care attribute compared with retail clinics more often staffed by nurse practitioners or physician assistants), were more important to patients in older age groups, while affordability and location were more important …

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