How Healthcare Reform Impacts Urgent Care

How Healthcare Reform Impacts Urgent Care

June 16, 2013
by Michael Barber
How Healthcare Reform Impacts Urgent Care

People who utilize urgent care centers should know the details about health care reform as it pertains to urgent care. In the recent past, there have been many policy changes and controversies to consider. Here are some of the fundamental things that patients must know.

Related: 7 Things You Don't Know About the Healthcare Reform

Insurers See Benefit of Smaller Networks

Insurance agencies such as Humana, the owner of Concentra urgent cares, see the benefit in keeping smaller pools of doctors and hospitals in order to keep premiums lower. For patients, this shift could spell the end of choosing any doctor, anywhere as a primary care provider. Some insurance providers tightened their networks a few years ago, and are already reducing their size again. This keeps the accountable care responsibility on a smaller care team of providers.

Traditional Doctors Are at Odds With Urgent Care Centers

Only 29% of American primary care physicians offer any sort of extend hours coverage for patients. Because of gaps in service like this, urgent care locations are growing: from 2007 to 2013 the number of locations grew from 8,100 to over 9,000. However, many health care reform lobbyists and policymakers agree that primary-care physicians need to be more involved in patients' care plans in order to offer better long-term health care, identify addictions, and treat chronic conditions. Patients are able to slip through the cracks of the health care system if they only use urgent care doctors because they are often different and do not have time to review lengthy medical histories, only presenting symptoms.

Emergency Rooms Are Being Over-Utilized

Experts agree that unnecessary visits to the ER have cost the US more than $4.4 billion. On average, 14-27% of all ER visits could have been handled at urgent care centers. For example, patients going to the ER for broken bones are wasting specialized doctors' time, their own money, and their insurance provider's money, because urgent care locations are perfectly equipped for broken bones. This waste is being noted and used as a talking point to make urgent care more predominant in health care. However, patient education is vital in this shift from ER care to urgent care. Patients need to know when to choose urgent care, and when an ER is necessary. Very few people understand the extent of services offered by most urgent care locations.

2014 Reform Creates Larger Doctor Shortage

More than three million patients visit urgent care centers each week because of the cost savings and ease of service. In 2014, when health care reform (known as "Obamacare") takes hold, an additional 32 million patients will be on the market for primary-care physicians at a time when the industry is already facing a shortage of approximately 150,000 doctors. Experts agree that this sudden flood of patients that have been waiting for years to be cared for may push current health care seekers to choose urgent care. While primary-care physicians are booked with appointments for new clients for two or three-weeks out, people with slightly more urgent conditions, such as a severe flu, will choose urgent care. This large backlog of patients could lead to shorter appointments and worse care, some fear. Health care reform affects all patients. Because of this, it is important for people to understand what has happened recently, and which issues are still being debated.