In late November, New Jersey lawmakers proposed Bill A5731, which amends one of the state’s statutes. The bill would mandate that providers in urgent care centers have degrees and qualifications equal to those required for hospital emergency department providers. The category would encompass all licensed professionals, including physicians, physician assistants, nurses, and nurse practitioners. The bill broadly defines “urgent care facility” as a health center offering episodic, walk-in care for non-life-threatening conditions. If passed, the bill could quickly produce a negative impact on daily operations and the profitability of urgent care centers. It’s very early in the legislative process, and the bill will ultimately need approval by both houses and Governor Phil Murphy, a democrat.
Let’s get real: “This represents old-school thinking, back to the days when urgent care centers were predominantly owned and operated by emergency medicine physicians,” says Alan Ayers, MBA, MAcc, president of Experity Networks and Practice Management Editor of JUCM. “The market has progressed over the last 20 years, and patients have learned to rely on urgent care for more common health conditions.” He notes that today only 35% of full time employees in urgent care come from an emergency medicine background with the balance coming from primary care specialties, according to the Urgent Care Association. Moreover, 84% of urgent care visits are delivered by nurse practitioners (NPs) and physician assistants (PAs), and according to the American Association of Nurse Practitioners, 88% of NPs are certified in primary care. Only 6% of the nation’s NPs are emergency medicine trained vs 13% of PAs. “Holding urgent care to emergency department standards ignores the current realities of the delivery model, alienates thousands of family medicine professionals working in urgent care today, and risks burdening primary care with routine concerns—thus reducing access for chronically ill patients. The scenario also would lead to a greater burden on emergency departments by Medicaid patients, who otherwise receive a scope of primary care services from urgent care centers,” Ayers says.