StuWilli, Author at Journal of Urgent Care Medicine

‘Step Therapy’ Usually Not What the Doctor Ordered

Proponents say “step therapy” will save the healthcare system big money while still allowing patients the medications they need. Opponents call it “fail first” and insist that the practice of having patients try cheaper versions of prescribed medications—with insurers paying for the more expensive variety only if the cheaper drug doesn’t do the job—is a bitter pill to swallow. Some clinicians claim the practice, which in effect has insurers overriding a prescriber’s choice of medications …

Tricare Urgent Care Pilot Now in Obama’s Hands

The “ayes” had it as Congress approved a three-year pilot program that waives preauthorization for Tricare beneficiaries who want to visit an urgent care center. Tricare provides civilian health benefits for military personnel, military retirees, and their dependents. Part of the Fiscal Year 2016 National Defense Authorization Act, the program will take effect six months after President Obama signs the bill (S. 1356) into law. At the end of year 1 of the pilot, the …

ACP’s take on concierge medicine

Urgent care operators considering adding a concierge medicine component to their business may find rationale to do so—or not to do so—in a new position paper published in the November 10 issue of Annals of Internal Medicine. The paper declines to give either a thumbs-up or a thumbs-down to direct patient contracting practices (DPCPs)—aka “concierge medicine”—but does offer perspective on the pros and cons relative to medical quality, cost, access, and other factors. On the …

Retail health expansion is no sure thing

Investing in the growth of the retail health segment continues to be a hit-or-miss proposition for major chains around the country. While Walmart is hoping it won’t strike out with its third iteration of a clinic offering, Safeway is pulling the plug on plans to offer “upscale” clinical services—the keystone of which would have been a vendor’s blood analyzer—in 800 stores. Safeway spent around $350 million to build the clinics, hoping the blood tests produced …

‘Defensive Medicine’ May Actually Lower Malpractice Risk

Findings of a new study seem to support the notion that “defensive medicine”—eg, ordering tests even when not specifically indicated clinically—may offer some degree of protection to urgent care centers and other medical facilities. The study, authored by a team from Harvard Medical School led by Anupam B. Jena, MD, PhD, found an inverse association between spending and probability of a malpractice claim. In other words, employing greater resources reduced the risk of a malpractice …

Undocumented Immigrants Lost to Insurance May Be Returning to Urgent Care

Undocumented immigrants who stopped showing up at urgent care centers after receiving health insurance under the Affordable Care Act may be back the next time they’re injured on the job or a child spikes a fever. Roughly 423,000 of those newly insured lost their coverage due to a Centers for Medicare and Medicaid Services (CMS) policy requiring proper documentation of immigration status or income within 95 days of getting coverage. Urgent care has been a …

Humana Moves Could Impact Older Patients and Urgent Care

Humana’s plan to lower the number of elderly patients who seek care in the emergency room could end up costing urgent care centers. The company is testing a telehealth program that encourages Medicare Advantage enrollees to try “virtual” visits for relatively minor complaints before they head to the hospital. On-call clinicians would have access to the patient’s medical history and the authority to direct the patient’s care (which could still entail a trip to the …

What the New Microchip Credit Cards Mean for Urgent Care

URGENT MESSAGE: Effective October 1, 2015, businesses that accept credit and debit cards can be responsible for fraud charges if they do not implement technology that reads the microchip-enabled cards now being issued by banks. Urgent care operators should work with their credit card processors to assure compliance through use of upgraded equipment that is compatible with their practice management systems. Alan A. Ayers, MBA, MAcc is Practice Management Editor of The Journal of Urgent …

Red Painful Eye with Visual Loss

A 29-year-old contact lens wearer presents to the urgent care center with a red eye, eye pain, and visual loss that has been increasing over the past 12 hours. Examination shows an injected conjunctiva with ciliary flush, and a cornea with white infiltrate in the stroma. View the image taken (Figure 1) and consider what your diagnosis would be.