Providers and Insurers Look to Urgent Care Facilities to Lower Costs

The expected cuts to Medicare via the Patient Protection and Affordable Care Act (“PPACA”) have many health care providers and insurers assiduously reviewing various efficiency and spending measures.  The latest edition of the Albany Business Review  highlights one emerging trend in these efforts: steering individuals with minor ailments away from hospital emergency rooms and into “urgent care” centers.  Those facilities offer treatment for situations that require immediate care but are not serious enough to require the intensive care provided by an emergency room.

The article, written by Barbara Pinckney, highlights the increased costs of a trip to the emergency room instead of an urgent care center (citing the example of a case of strep throat costing roughly seven times more when treated in a hospital emergency room), as well as the efforts of providers and insurers to encourage patients to seek out consultation at urgent care facilities for relatively minor ailments.  Insurers have repeatedly found that raising the co-pay for emergency room visits has been ineffective, and they are switching to patient education efforts, such as updating urgent care center location and co-pay information on member identification cards and commencing information campaigns to highlight the availability of urgent care.  Other insurers have encouraged participating primary care doctors to offer more walk-in availability for care that cannot wait for a formal appointment.  Meanwhile, hospitals are also opening their own urgent care centers to deal with non-emergency situations.

This post was contributed by David Nardolillo.