“Over the past two years, hospital chains and insurance companies have snapped up urgent-care centers in a spate of mergers and acquisitions.”
Traditional Providers Get Into the Urgent-Care Game
Urgent-care centers are on the rise, driven by demographics and insurance
By LAURA LANDRO
March 20, 2016 10:04 p.m. ET
When it comes to health issues that need immediate attention but aren’t life-threatening, more Americans are turning to urgent-care centers—and traditional health-care providers are getting into the game.
Over the past two years, hospital chains and insurance companies have snapped up urgent-care centers in a spate of mergers and acquisitions. Health systems, too, are moving into this space, striking joint ventures with independent urgent-care operators, says Tom Charland, chief executive of consulting firm Merchant Medicine.
One driver of these investments is the rise in active patients over 50 who want convenient care for injuries and illness, yet prefer being connected to a larger system where their regular doctor may practice and where urgent visits can become part of their medical record, Mr. Charland says.
Estimates of the number of centers in the U.S. are as high as 10,000. The Urgent Care Association of America says it counts about 7,100 full-service urgent-care centers, with 22% owned by hospitals and 15% in joint ventures with hospitals. Surveys by the group show that some 87% of urgent-care-center operators acquired or built a new location in 2014, and that 89% said patient visits increased in 2014 from the previous year.
For patients, urgent-care centers connected to a health system offer the dual benefit of convenient care and some assurance that they can be quickly transferred to an emergency room or referred to a primary-care doctor or specialist. Conversely, hospitals can steer patients in crowded ER waiting rooms to an affiliated urgent-care center nearby if it isn’t a true emergency.
Medicare patients
Randy Johansen, president of American Family Care, a Birmingham, Ala.-based operator of urgent-care centers, says his company’s centers see a significant number of Medicare patients who have primary-care doctors to manage ongoing conditions like diabetes and high blood pressure but may have a problem that needs immediate attention. American Family Care has some joint ventures with health systems and hospital groups, but its centers that aren’t affiliated with a hospital also have transfer agreements for more serious emergencies.
Most urgent-care centers, which have physicians on staff and operate on a walk-in basis, offer wait times of 30 minutes or less, versus an average wait of four hours for an emergency-room visit, the urgent-care association says. The average cost of an urgent-care center visit is $150 compared with $1,354 for an ER visit, and urgent-care centers accept insurance, with copays similar to a primary-care visit. Most important, perhaps, the centers are usually open evenings and weekends when doctors’ offices are typically closed.
They have X-rays, lab tests and other diagnostic equipment and handle common illnesses and injuries such as sprains, animal bites, mild asthma, rashes and minor burns, ear or sinus pain and respiratory infections. They can treat minor fractures and allergic reactions and remove foreign objects from eyes or noses.
Ateev Mehrotra, an associate professor in health-care policy at Harvard Medical School, says health systems may see urgent-care centers as a new way to funnel patients into their system and keep existing patients from going elsewhere. For example, provisions of the Affordable Care Act base some payments on coordination of care, and if patients are visiting unaffiliated urgent-care centers, the system to which those patients belong may lose revenue.
For reassurance as to quality, patients can ask whether an urgent-care center is accredited or certified by one of three groups: the Urgent Care Association of America, the National Urgent Care Center Accreditation program, or the Joint Commission, an independent nonprofit. Though voluntary, such designations indicate that a center has passed through a quality review. Doctors can also be board-certified by the American Board of Urgent Care Medicine.
Some experts warn that patients who use urgent-care centers may not establish or maintain a relationship with a primary-care doctor who can provide personalized care and monitor health issues such as chronic illness over time.
But the urgent-care association says about 66% of urgent-care patients have an outside primary-care doctor.
John Gardner, 48, says he and his family have relied on an American Family Care Center in Greenville, S.C., near their home to treat problems ranging from ingrown nails to ear infections. He has a primary-care doctor and believes it is important to keep that connection. Nevertheless, Mr. Gardner says, in his experience, going to the urgent-care center is “so much easier for 95% of the things you come across than trying to get a doctor’s appointment.”
Under a franchise agreement with American Family Care, Bon Secours St. Francis Health System in Greenville acquired the center Mr. Gardner uses and three others in November, and has the rights to build four more. Bon Secours operates hospitals and rehabilitation facilities, and has its own physicians group with 250 doctors, enabling it to link urgent-care patients to ongoing care.
Craig McCoy, chief executive of Bon Secours St. Francis Health System, says his company’s urgent-care investment allows the system to provide the level of quality its patients are used to in a “sustainable” cost model. “We are responding to the voice of the customer: treatment at their convenience, expanded hours, quick visits and superior customer service,” he says.
Timely help
Dave Hamilton, 50, had been doing contract maintenance work at an American Family Care clinic in Hoover, Ala., and was driving to his next appointment when he started to feel what he thought was horrible indigestion—accompanied by pain in his chest and numbness in his arm. He called his wife, who told him to pull over and call an ambulance. But instead he turned around and drove back to the clinic.
There, Mr. Hamilton told the manager, “I think I’m having a heart attack.”
In minutes, the urgent-care staff examined him, gave him nitroglycerin and aspirin to help improve blood flow through his arteries, and called an ambulance to transport him to a hospital in nearby Birmingham.
Says Mr. Hamilton, “They had the knowledge and ability to give me the right care when I needed it.”
Ms. Landro is an assistant managing editor for The Wall Street Journal and writes the Informed Patient column. Reach her at:laura.landro@wsj.com.
