Why Urgent Care Centers Are Popping Up Everywhere

New York
CNN
—

A drive through busy suburban malls or a walk through the streets of a big city won’t last long without finding a Concentra, MedExpress, CityMD, or other emergency care center.

During the Covid-19 pandemic, demand in emergency medical settings surged as people searched for tests and treatments. Patient numbers have surged 60% since 2019, according to the Urgent Care Association, an industry group.

This has fueled the growth of new urgent care centers. A record 11,150 emergency care centers have sprung up across the United States, growing at a rate of 7 percent annually, according to industry groups. (This does not include in-store clinics such as CVS’s MinuteClinic or independent emergency departments.)

Emergency care centers are designed to treat non-emergency conditions such as the common cold, ankle sprains, ear infections, and rashes. Recommended if the patient cannot make an appointment with their primary care physician immediately, or if the patient does not have a primary care physician. In such situations, primary care practices should always be called first. Because primary care practices have access to patient records and all medical history. Emergency care sites, on the other hand, are intended to provide temporary care.

Physician’s assistants and nurses are often present in emergency medical settings. Many facilities also have doctors on staff. (In 2009, 70% of his providers were doctors, according to an emergency care industry magazine, but by last year that percentage had dropped to 16% for him.) From a trip to the emergency room less.

Emergency care is growing rapidly due to convenience, gaps in primary care, high costs of emergency room visits, and increased investment by the health system and private equity groups. According to IBISWorld, the emergency care market’s revenue this year is expected to reach about $48 billion, up 21% from 2019.

This growth highlights the crisis in the US primary care system. According to the Association of American Medical Colleges, there will be a shortage of up to 55,000 primary care physicians over the next decade.

However, many doctors, health care advocates and researchers have expressed concern over the proliferation of emergency care sites, saying there may be downsides.

Frequent visits to emergency care sites can weaken established relationships with primary care physicians. Research shows that they can also lead to more fragmented care and increase overall health care costs.

There are also questions about the quality of care at emergency care centers and whether they adequately serve low-income communities. A 2018 study by Pew Charitable Trusts and Centers for Disease Control and Prevention found that antibiotics are being over-prescribed, especially in common cold, flu and bronchitis emergency care centers.

Vivian Ho, a health economist at Rice University, said: “If you want ongoing management of your chronic illness, you shouldn’t go there.”

Urgent care centers have existed in the United States since the 1970s, but have long been ridiculed as “paper in a box” and grew slowly in the early days.

It has grown in popularity over the past two decades, partly due to pressure on the primary care system. People’s expectations of wait times are changing and it is difficult, and sometimes almost impossible, to schedule an immediate visit to a primary care provider.

Emergency medical facilities are typically open longer hours on weekdays and weekends, making appointments and walk-in visits easier. About 80% of the US population is within a 10-minute drive of an emergency care center, according to industry groups.

Susan Kressly, retired pediatrician and Fellow of the American Academy of Pediatrics, said:

Health insurance companies and hospitals are also focused on keeping people out of emergency rooms. A visit to the emergency room costs about 10 times more than a visit to the emergency center. In the early 2000s, hospital systems and health insurance companies began opening their own emergency care sites and implemented strategies to discourage emergency room visits.

Additionally, the passage of the Affordable Care Act of 2010 spurred a surge in emergency care providers as millions of newly insured Americans sought medical care. Private equity and venture capital funds have also poured billions into the emergency center deal, according to PitchBook data.

Urgent care centers are attractive to investors. Unlike ERs, which are legally mandated to treat everyone, emergency care facilities essentially have a choice of patients and conditions to treat. Many emergency care centers do not accept Medicaid and can refuse uninsured patients unless they pay a fee.

Like other medical options, emergency care centers generate revenue by charging insurance companies for visits, additional services, or costs that patients pay out-of-pocket. A FAIR Health study found that in 2016, the median charge for a 30-minute new insurance patient visit was $242 at emergency care centers, $294 at primary care offices, and $109 at retail clinics. Health insurance data.

Ateev Mehrotra, a professor of health policy and medicine at Harvard Medical School who has studied emergency care clinics, said: “It’s not a place where you can make a lot of money in healthcare, but we have quite a few patients.”

A Mehrotra study found a 119% increase in emergency care visits between 2008 and 2015. They have become a go-to place for people seeking treatment for mild conditions such as acute respiratory infections, urinary tract infections, rashes, and muscle aches.

Some doctors and researchers worry Patients with and without a primary care physician visit the emergency department on behalf of their primary care provider.

“What you don’t want to see are people seeking more care outside pediatricians and fewer visits to primary care providers,” says Rebecca Burns, director of emergency medicine at Lurie Children’s Hospital in Chicago. has said.

Barnes’ study found that high reliance on emergency medical care can meet the needs of children with acute problems, but can disrupt the primary care relationship.

The National Health Law Program, a health care advocacy group for low-income families and communities, advocates coordination between emergency care sites, retail clinics, primary services, and hospitals to ensure continuity of patient care. We are requesting that the regulations of

And while the presence of emergency care centers keeps people from seeing costly emergency department visits for low vision problems, Harvard’s Mehrotra paradoxically increases net medical costs. I discovered that

Every $1,646 visit to the ER for a prevented low vision condition was offset by $6,327 in increased emergency care center costs, his study found. This is because there is a possibility of going to urgent care for a mild illness that was being treated with chicken soup.

There are also concerns about oversaturation of emergency care centers in high-income areas, where more consumers are using private health care and access to underserved areas is limited.

A 2016 study by researchers at the University of California, San Francisco found that emergency medical centers were being used in rural areas, areas with high concentrations of low-income patients, and areas with low concentrations of privately-insured patients. They tend not to serve selectively. They said this “uneven distribution could exacerbate health disparities.”