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Help Urgent Care Medicine Get a Boost from Legislators

Source: The Case for Urgent Care, September 1, 2011, Urgent Care Association of America

What is Urgent Care?

As defined by the Urgent Care Association of America, Urgent Care is healthcare provided on a walk-in, no-appointment basis for acute illness or injury that is not life or limb threatening, and is beyond the scope or availability of the typical primary care practice or retail clinic.

Urgent Care centers provide walk-in, extended-hour care for illnesses and injuries that do not belong in an emergency room. Typical urgent care services include physicals, immunizations, xrays, blood and urine tests, fracture and laceration care, EKG’s, oxygen and intravenous fluids. They are owned by physicians, groups of physicians, hospitals and corporations and are staffed with qualified and experienced physicians, physician assistants and nurse practitioners.

Did You Know?

  • Urgent Care Centers have been open in the U.S. for over 30 years.
  • Since the 1990’s the number of Urgent Care Centers increased from 4,000 to 9,000.
  • The U.S. healthcare system faces increased patient needs, decreased access to care, rising costs, and growing demands on primary care and emergency care systems.
  • Independent studies show that Urgent Care improves access and lowers cost, but no global review has been done at a legislative level.
  • The current healthcare reform dialogue emphasizes use of advanced primary care and primary care physicians as the solution for lowering costs.
  • There is no inclusion of Urgent Care in any of the recent federal healthcare legislation.
  • Urgent Care’s role to help our healthcare system has not yet been examined.Access to Care
  • As of June 2011, according to the Department of Health and Human Services, there are over 66 million people living in a primary care health professional shortage area.
  • In 2007 that number was at 56 million.
  • Only 57% of Americans report having same or next-day access to primary care.
  • 63% have difficulty finding care evenings, weekends or holidays. The ER is the only option. In 2010 20% of adults reported waiting six days or more to see a doctor.

Projected Physician Access

  • By 2020, there will be 45,000 too few primary care physicians.
  • By 2025 the over-65 population will grow to 80 million.
  • The Patient Protection and Affordable Care Act will provide healthcare coverage for a new group of 32 million individuals, which will add to the physician access shortfall.
  • The demanding role of primary care physicians includes extensive patient education, diagnosis, treatment, and follow up, limiting time for new and limited access patients. Enhanced Primary Care Physician Options
  • Primary Care Physicians can expand their hours to add more unscheduled patients, but this does not address the projected shortfall in primary care physicians in ten years.
  • Urgent Care centers can handle episodic urgent patient visits in a collaborative and mutually supportive manner with primary care physicians.
  • Partnering with an urgent care center, which already has extended hours, can costeffectively absorb primary care overflow patients.

Emergency Department Realities

  • Emergency departments are overcrowded and high-cost for non-emergency care.
  • Crowded ERs threatens timely patient care, resulting in prolonged pain and suffering.
  • The number of emergency departments is falling and visits are increasing.
  • ERs provide a disproportionate share of services to Medicaid and uninsured patients.Increasing rates of ER visits by the elderly in an aging population can lead to “catastrophic overcrowding.”
  • Average ER wait times are approximately 4 hours.
  • Contributing to over-crowded ERs is non-emergency care in the ER department.
  • Urgent care centers can help lower cost of non-emergency care.
  • For hospitals and ERs, high costs will continue to rise.
  • The population will continue to age and require more care.

Measuring and Lowering Costs

  • Cost savings for an urgent care visit versus an emergency room visit for the same diagnosis ranges from $228 – $583.
  • At 31.64 million non-emergency visits, the cost savings of using an urgent care center instead of an ER could range from 7.22 – 18.45 billion dollars annually.
  • This difference in cost is the most significant issue with the use of the emergency department as a panacea.
  • By its nature, most non-emergency care can wait until morning. Pilot Programs for Lowering Costs
  • Some insurance payers already recognize the cost-savings that urgent care represents and are educating patients about their alternatives for non-emergency treatment.
  • One of Wellpoint’s health plans, Anthem Blue Cross and Blue Shield in Virginia, reviewed their visit data and found that more than 60% of ER visits for members were for diagnoses that could have been treated at urgent care centers.
  • After launching a patient education initiative, Anthem saw a 14% decrease in ER visits in one year among members who were part of its program.

Current and Future Roles for Urgent Care

  • With the industry’s growth, urgent care is available in more communities and can now be considered as part of the solution to lowering U.S. healthcare costs.
  • The viability of urgent care centers for creating access while keeping cost low is in their existing capacity to absorb episodic primary care visits and non-emergency ER visits.
  • Even without concerted federal or state efforts, use of urgent care centers is rising.
  • Current access and capacity in communities with urgent care centers is successful based on an average patient wait time of approximately 20 minutes for 74% of patients.The growth rate of urgent care centers indicates continued building of capacity to absorb additional visits.
  • What is missing is national discussion of this capacity and its potential to save billions of dollars to the U.S. healthcare system.
  • In the future, urgent care centers could be considered as key sites for non-emergency treatment in a disaster. If hospitals are overwhelmed with serious injuries, urgent care centers could be designated as treatment sites for less critical patients.
  • Community officials could establish a network of the centers in their areas and include them in public notifications of disaster planning programs.

How YOU Can Help

  • Find the nearest urgent care center to where you live and use it for acute, but nonemergency visits when you do not have access to your primary care physician.
  • Write to your local, state, and federal legislators and emphasize that urgent care must be considered as part of the national U.S. healthcare reform.
  • Educate family, friends and neighbors about urgent care and how important it is to use these facilities and ask them to write to their legislators as well.

For more information, visit the Urgent Care Association of America website at: www.ucaoa.org

This document was extracted by Urgent Care of Connecticut from The Case of Urgent Care, UCAOA, September 1, 2011 in an effort to generate awareness of the importance of urgent care and the impact it could have on reducing cost in our healthcare system. Urgent Care of Connecticut has four locations in Southbury, Brookfield, Norwalk and Ridgefield and is growing and added approximately 100 jobs to Connecticut. For more information about Urgent Care of Connecticut visit our website at www.ucofconnecticut.com.

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