If School Nurses Provide Virtual Urgent Care, Who Pays?

On the surface, it sounds like a great way to see children getting the care they need as soon as possible. However, questions abound about the feasibility of a new program that gives students in Greene County (Tennessee) Schools access to virtual urgent care under a partnership between Niswonger Children’s Hospital and First Assist Urgent Care. Basically, the Niswonger Virtual Health Clinic offers students online access to doctors and nurse practitioners within their school nurse’s office. If a student in the nurse’s office is found to need a higher level of care than that nurse can provide, the student can be examined virtually by a First Assist Urgent care physician or nurse practitioner. That provider and the school nurse determine if the student can stay in school or if someone needs to pick them up. After the visit is complete, the provider is supposed to give the child’s pediatrician or primary care provider a full report. No one argues that the school nurses aren’t up to the task; rather, the question is whether bringing outside providers into the nurse’s office, virtually, means school systems will start seeing onerous spikes in their costs. If a parent took his or her own child to an urgent care center, that would typically be billed to Medicaid, insurance, or the parents. “Free” care provided in the school nurse’s office would be offered at the expense of the school district.