The surge in urgent care centers: emergency department alternative or costly convenience?

Abstract

As the U.S. health care system grapples with strained hospital emergency department (ED) capacity in some areas, primary care clinician shortages and rising health care costs, urgent care centers have emerged as an alterna­tive care setting that may help improve access and contain costs. Growing to 9,000 locations in recent years, urgent care centers provide walk-in care for illnesses and injuries that need immediate attention but don't rise to the level of an emergency. Though their impact on overall health care access and costs remains unclear, hospitals and health plans are optimistic about the potential of urgent care centers to improve access and reduce ED visits, according to a new qualitative study by the Center for Studying Health System Change (HSC) for the National Institute for Health Care Reform. 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 urgent care centers as a way to gain patients, while health plans see opportu­nities to contain costs by steering patients away from costly emergency depart­ment visits. 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. Looking ahead, health coverage expansions under national health reform may lead to greater capacity strains on both primary and emergency care, spurring even more growth of urgent care centers.