Journal of Urgent Care Medicine

Will Rising Out-of-Pocket Costs Drive More Patients to Urgent Care?

Employers and insurers can expect to see a 6% increase in healthcare costs in 2019, according to the Medical Cost Trend report just released by PwC. If that’s the case, rest assured they won’t just be eating the cost, but passing the bump along to employees and plan members. Given that 12% of wages are presumed to go toward healthcare, all concerned parties will be looking to do more with less—which may make urgent care …

Anthem ED Policy is Starting to Rankle Patients

When Anthem announced some months ago it would not cover bills for “unnecessary” (in their retrospective view) trips to the emergency room in some states, we noted objections from physician groups. Now that the policy is in place and claims for 2018 have started to be filed, we’re seeing media reports on angry patients who are getting stuck with bills they presumed would be covered. Consumer Reports, for one, recounts the case of a patient …

New Data Exchange Models Serve Urgent Care’s and Payers’ Interests

Patient population data rooted in urgent care visits could be invaluable to healthcare systems, especially with patients who don’t have a primary care physician. And, of course, urgent care operators want to be included in local provider networks. Current and emerging technologies, as well as growing emphasis on value-based care, make this the perfect time to strike formal partnerships to exchange electronic patient data, providing a path for both parties toward their goals. It’s incumbent …

New Data: Hospital Bills Don’t Discriminate Between Insured and Uninsured

New data from the National Bureau of Economic Research (NBER) indicate that while the Affordable Care Act (ACA, or “Obamacare”) has made sure more Americans have health insurance, it has done little to make care more affordable across the board. While nearly 90% of the country has coverage, NBER statistics show that more people than ever find basic healthcare unaffordable. A recent study of over 1 million patients from 2003 to 2007 illustrates just how …

‘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 …