For 42% of survey respondents, urgent care centers are among the tactics used to minimize avoidable ED visits. At AMITA Health, urgent care centers coordinate closely with primary care. "In our system," Cassidy says, "the urgent care clinics are connected to a primary care office. They do everything they can to make sure that the patients who come to urgent care have a primary care physician."
Nadworny notes that the urgent care center can place a patient on a path of coordinated care. "Our urgent care providers are making decisions not only for the condition of the moment but also decisions about how to plug that patient into the healthcare system. That gives us a new benefit. Urgent care is not only a point of care but also a point of entry to the organization. So that person now is getting not just the urgent care coverage, but they're getting introduced into the network and getting more definitive care set up for them."
Patient knowledge, patient preference
Four-fifths (81%) of healthcare leaders from organizations with urgent care clinics or that are planning urgent care clinics say that the need to provide a setting for patients with nonemergent conditions is among their top motivations for pursuing an urgent care clinic. More than half (52%) say they want to improve access through extended hours.
The broader trend behind taking advantage of additional care settings and paying more attention to care coordination is that providers are helping patients to become more aware of their choices. So both patient and provider play a role in the patient receiving care in the appropriate setting.
Compared to last year's survey, there are decreases in the percentages of healthcare leaders who expect increases in uninsured/self-pay (50% to 41%, down nine points) and nonemergent ED patients (45% to 32%, down 13 points).
Cassidy observes two dynamics at work: "A couple of things are happening now that a significant number of patients who were uninsured are now on the exchange. Number one, some are learning how to use their health insurance and are calling a primary care physician instead of going to the ER. When you're not insured, it's not always easy to get a physician appointment." Second, insured patients see a difference in out-of-pocket costs, as well. "Patients are beginning to recognize the difference in the bill if they go to the ER or if they go to a doctor's office."
Michael Zeis is a research analyst for HealthLeaders Media.