An analysis by the Washington Post and Kaiser Health News examined the recent trend of hospitals launching combined urgent care (UC) centers and emergency departments (EDs). One of the benefits of the hybrid centers is that patients don’t have to self-triage and decide on their own which level of care they need. As it turns out, in the real world of these hybrid centers, many patients can be treated appropriately at the UC level. For example, UF Health in Jacksonville, Florida, bills about 70% of patients at its hybrid center at urgent care rates, according to the news report. However, patient advocacy organizations have raised concerns that hybrid centers may skew toward ED triage because it’s likely to lead to higher reimbursement for the hospital system, although there’s no data yet to demonstrate the efficacy of the triage systems in place at the hybrid centers. For UF patients, if ED-level care is needed, UF informs the patients in advance that they will be billed for the ED visit. If the patient decides to leave and seek care somewhere else, they are still charged a triage fee, according to the report. Those who self-pay for urgent care services without insurance are charged a $250 flat fee at UF.
24-hour triage: “A triage process exists during the day in which emergent cases are seen on the ED side and non-emergent as urgent care. But after a certain time, often 10 pm, all patients are seen on the ED side,” says Alan Ayers, MBA, MAcc, president of Experity Consulting and Senior Editor of JUCM. “Although there are often facility fees on the ED side, the model allows 24-hour access to care with greater efficiency than an urgent care or freestanding department alone.” The hybrid model is positioned for growth. UF Health is just one of several health systems across the country partnering with private-equity-backed Intuitive Health, which was founded by a group of emergency medicine physicians in 2008, to launch combined UC/ED access points. Baptist Health Kentucky recently broke ground on its third hybrid center—yet more evidence of either the success of, or the optimism for the centers. As another example, VHC Health in Arlington, Virginia, is also planning to build a hybrid facility later this year.
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