Hospitals and health systems are taking different roads on how to provide urgent care, with some choosing to partner with urgent-care center operators and others building their own. They see urgent care as a way to provide access to patients at lower cost than in their emergency department.
Hospitals increasingly have shifted away from seeing urgent-care centers as competitors to seeing them as strategic partners in improving patient outcomes and satisfaction and reducing costs, experts say.
Steve Sellars, CEO of Baton Rouge, La.-based Premier Health Urgent Care, said his company has 50-50 joint venture deals with five health systems to operate its 30 centers in Louisiana. That arrangement, he said, has been beneficial because it has allowed his company and the health systems to share startup and operational costs. The centers also give the hospitals access to a large volume of potential new patients. Premier's centers have 325,000 patient visits a year, he said.
“In our partnership with a health system, we're there when a primary-care physician isn't available,” he said.
Other health systems have developed their own urgent-care centers as part of their integrated delivery network. MedStar Health, a 10-hospital system based in Maryland, operates an urgent-care network called MedStar PromptCare, with 11 locations throughout Maryland and Washington. “We're the front door to MedStar,” said Ulana Bilynsky, MedStar's assistant vice president of ambulatory services.
When a health system runs its own urgent-care center, the center's role in relationship to the health system is better defined than if patients use freestanding urgent-care centers, Bilynsky said. PromptCare serves as a way to help MedStar reduce its rate of hospital readmissions by offering outpatient care to patients who were recently discharged from the hospital and who may experience health issues that aren't serious enough to warrant a visit to the emergency department or hospital readmission. In addition, PromptCare helps generate referrals for MedStar if patients who visit the urgent-care center are in need of additional services.
The number of urgent-care centers has increased steadily over the past several years, from 8,000 facilities in 2008 to more than 9,300 currently. The centers see between 71 million and 160 million patients annually, according to the Urgent Care Association of America.
Urgent-care centers differ from retail clinics in that they provide a more intensive level of services for more serious conditions. They also have staff physicians who can treat most conditions that are not life-threatening.
Hospitals see urgent care as a way to divert patients from overcrowded and costly emergency departments, and that's particularly attractive if they are participating in capitated or value-based payment arrangements where they get dinged for costly and unnecessary ED visits or hospitalizations.
Many experts see urgent-care centers as a way to make care more quickly accessible to patients and boost customer satisfaction. “Urgent-care centers are able to provide that convenience that patients are looking for,” said Sellars, president-elect of the urgent-care association.