Urgent Care Centers: Emergency Department Alternative or Costly Convenience?
Consumer demand for more convenient and timely access to care for illnesses and injuries is a major driver of the rapid growth of urgent care centers across the country, according to a new qualitative study by the Center for Studying Health System Change for the nonpartisan, nonprofit National Institute for Health Care Reform.
There are now nearly 9,000 urgent care centers around the country. Across the six communities studied — Detroit; Jacksonville, Fla.; Minneapolis; Phoenix; Raleigh-Durham, N.C.; and San Francisco — respondents indicated that growth of urgent care centers is driven heavily by consumer demand for convenient access to care. At the same time, hospitals view owning urgent care centers as a way gain patients, while health plans see opportunities to contain costs by steering patients away from costly emergency department visits, according to the study.
Historically, urgent care centers often were independently owned, stand-alone facilities, but the landscape has changed considerably, according to the study. Large urgent care center chains operate in some regions, and hospital systems are establishing urgent care centers to expand their service area and referral base. More recently, health insurers are partnering with or establishing urgent care centers as a strategy to control spending growth by shifting some care from emergency departments to lower-cost urgent care centers.
"Overall, respondents perceived that urgent care centers improve access to certain services for privately insured people without significantly disrupting care continuity, but respondents were uncertain about urgent care centers' impact on costs," said Ellyn R. Boukus, an HSC health research analyst and coauthor of the study with Tracy Yee, a former HSC researcher; and Amanda E. Lechner, M.P.P., an HSC health policy analyst.
Although some providers believe urgent care centers disrupt coordination and continuity of care, others believe these concerns may be overstated, given urgent care's focus on episodic and simple conditions, rather than chronic and complex cases, the study found.
The study's findings are detailed in a new HSC Research Brief, "The Surge in Urgent Care Centers: Emergency Department Alternative or Costly Convenience?," available online at www.hschange.org/CONTENT/1366/.
Other key findings include:
- Access to care. Urgent care centers fill an access gap by providing walk-in care, especially during evening and weekend hours, for patients without a primary care physician or those unable to schedule a timely PCP appointment. While urgent care centers don't increase the overall number of primary care clinicians because they draw from the existing supply of PCPs, they may improve access to primary care services by offering more convenient availability, especially during evenings and weekends, when primary care offices are typically closed.
- Care coordination. Most respondents perceived that urgent care centers do not significantly disrupt existing relationships with primary care providers or coordination of patient care. One reason is that many patients treated at urgent care centers have acute needs that can be handled in isolation from other health care needs or conditions.
- Cost savings. The impact of urgent care centers on health care costs remains unclear. Respondents across the board reported a lack of data to show whether the growth of urgent care centers has generally saved money by diverting patients away from emergency departments or increased costs by drawing patients from primary care practices.