Are Hospitals Too Late to the Urgent Care Game?

Treatment at your convenience? Expanded hours? Quick visits? Lower costs? Good customer service? All potential reasons to visit your nearest urgent care center (if need be, of course!). There, health-care providers will attend to your non-life-threatening injury or illness, helping you to avoid a crowded emergency room or, perhaps, helping you to avoid an inordinate amount of time waiting for an appointment with your primary care physician.

Free-standing urgent care centers have been around for a while and many services are covered by insurance networks, while being promoted by employers, administrators, and insurance carriers as a cost-effective and convenient way to seek medical treatment. The increased demand for high-quality, convenient, and non-critical medical care is contributing to their continued growth. A 2010 Health Affairs study found that 13 - 27% of all emergency department visits could take place at an urgent care center or a retail clinic.

Although 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, The Urgent Care Association of America (UCAOA) reports that 66% of patients have an outside primary care physician.

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 (ER) visit, while the average cost of an urgent care center visit is $150 compared with $1,354 for an ER visit. 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 can treat minor common medical illnesses and injuries such as sprains, animal bites, minor burns, and respiratory infections.

UCAOA reports there are 7,100 full-service urgent care centers in the country. According to a UCAOA report, 22% are owned by hospitals, 15% are joint ventures with hospitals, and 19% are corporate-owned entities.

What is new in the last several years is the increase in the number of urgent care centers affiliated with hospitals. Seeing the benefits in offering urgent care as a way to fill the need between emergency care and primary care, hospital systems and insurance companies have purchased urgent care centers in a series of mergers and acquisitions, while some health systems have partnered with independent facilities. Urgent care can improve access to care and help alleviate emergency department overcrowding. Integrating such services into their operations allows patients who need follow-up care to see a specialist in the health system. Hospitals can, also, steer patients from crowded emergency rooms to an affiliated urgent care center nearby if it isn't a true emergency. For doctors, it helps eliminate non-emergency cases from emergency rooms, leaving ER doctors free to focus on critical cases.

Will an urgent care center tied to a larger hospital system improve the patient experience? Do patients have more confidence in urgent care facilities that are associated with hospital systems versus those that are not?

According to a Wall Street Journal article, patients, especially those over 50, like urgent care centers connected to a larger system. 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. They may, also, like the familiarity of a facility being associated with a brand-name hospital, and, also, favor that their visits can go directly into their medical records already, perhaps, maintained with the hospital system. Being connected to a larger system where their regular doctor may practice and where urgent care visits can become part of their medical record is a much more convenient and seamless transaction.

Certainly, owning and operating urgent care facilities is a way for hospitals to link urgent care patients to ongoing care by moving new patients into their system and keep existing patients from going elsewhere. However, hospitals generally specialize in intensive care, surgical procedures, and complex diagnostic testing, and may not meet the routine needs of the outpatient community where customer service, care quality, and efficiency are paramount.

It is anticipated that increased interest by hospitals in urgent care centers will continue in some form or fashion, either by acquiring such facilities and incorporating them into their existing outpatient care structure, or by partnering with others to develop urgent care platforms, as part of integrated health systems.