Journal of Urgent Care Medicine

UnitedHealth Starts Making Good on Threats to Leave ACA Programs

UnitedHealth Group has been saying for months that it may opt to not participate in insurance exchange programs set up under the Affordable Care Act (ACA, or “Obamacare”). Apparently it was no idle threat, as the biggest insurer in the country says it will not sell plans in Arkansas or Georgia next year. The company has said the ACA plans are not profitable enough to justify their participation. UnitedHealth and Aetna both saw losses on …

Patients Don’t Associate Higher Cost with Better Care

Apparently, patients don’t see a need to pay Cadillac prices for the “Cadillac” of healthcare services (wherever they may exist). Most participants in a new report published in Health Affairs don’t associate higher cost with higher quality when it comes to making healthcare decisions—a departure from the expected consumer mindset when it comes to buying other goods and services. Among the questions included in the survey: “Would you say higher prices are typically a sign …

Colorado Bill Would Force Freestanding ERs to Be More Open on Costs

Colorado is considering legislation that would require freestanding emergency rooms to post notices throughout the building alerting patients that they have stepped into an emergency room, where they will be afforded emergency care for emergent medical conditions (and pay emergency-level charges). The bill was inspired by complaints from consumers who have mistakenly sought care in freestanding ERs, thinking they had gone to an urgent care center—where costs are lower and more likely to be covered …

Pilot Program Allows Tricare Members to Report Directly to Urgent Care

Military members and their families covered under Tricare Prime, Tricare Prime Remote, or Tricare Young Adult–Prime will be allowed two urgent care visits without a referral per year, thanks to a pilot program starting May 23. Right now, beneficiaries need a referral before going to urgent care. Delays in getting appointments with a primary care provider have been a common complaint among military families for years, putting pressure on the Department of Defense to reconsider …

Potentially Avoidable ED Visits Cost Over $1.3 Billion—in New York Alone

If just 10 common, low-acuity conditions had been treated somewhere other than the emergency room, the health system in New York could have saved $1.3 billion, according to state Department of Health claims data analyzed by Excellus BlueCross BlueShield. That analysis takes into account 6.4 million ED visits—more than 2 million of which were deemed suitable for treatment in an urgent care center, primary care office, or via telemedicine—for “bumps and bruises,” joint aches, ear …

CDC Shifts Focus—and Ebola Funds—in Fight Against Zika

As concerns surface that a warm summer may spread Zika virus to New York City and Los Angeles, the Centers for Disease Control and Prevention has opted to take $589 million earmarked for Ebola virus initiatives and apply it to fighting Zika instead. The CDC has also warned that the mosquito that carries Zika is on the move. While initial reports suggested that U.S. Zika cases were limited to individuals who had traveled to affected …

U.S. Tuberculosis Cases Up for the First Time in 23 Years

After a decades-long slog toward elimination of tuberculosis in the United States, 2015 saw a slight increase in the number of domestic TB cases. While around half of all reported cases occurred in Texas, California, Florida, and New York, 29 states and the District of Columbia reported increases over 2014. While the Centers for Disease Control and Prevention suggests that lower funding of TB prevention programs may be on reason, urgent care clinicians faced with …

Denver Health Loses a CEO, Gains an Urgent Care Profile

Denver Health is ready to join the ranks of health systems that are diversifying its service offerings to include urgent care—and will do so in a big way, but without Arthur Gonzalez. Chief executive officer since 2012, Gonzalez resigned just a week before the opening of a $27 million, 4,500-square-foot clinic that will house an urgent care center, along with primary care and specialty services. The new complex will sit in an underserved section of …

Blue Cross Blue Shield: ACA Enrollees Less Healthy, More Expensive

A new report from Blue Cross Blue Shield reveals that its Affordable Care Act enrollees are sicker and more expensive than its other plan members, as a whole. In fact, they’re nearly twice as likely to be admitted to hospitals. One reason will come as no surprise to critics of the ACA, or “Obamacare:” People who were uninsured and less healthy in the first place have signed up in droves. The act requires participating insurers …

U.S. Workers More Concerned with Cost than Choice of Providers

Cost appears to be more important than choice of physician for U.S. workers, according to a new survey by the Employee Benefit Research Institute. Premiums were cited as a “major factor” when choosing a health plan by 79% of participants, compared with only 53% who cited a plan’s provider network. These data align well with key attributes of the urgent care setting (eg, easy access, relatively low cost, and convenience). Only 66% said they are …