Up to 19 new urgent care centers will be rolled out across
Hospitals and clinics that have been offering urgent care for several years also are promising expansions, setting up a battle to retain patients and capture new business.
Urgent care operators cite the potential savings of keeping people out of pricey emergency rooms, while some observers lament that the proliferation could drive up costs by undercutting efforts to coordinate patient care.
Most agree that the growth reflects a broader shift toward retail-style medical services that aspire to make seeing the doctor as easy as buying a gallon of milk.
"It's all a drive to consumer-friendly health care -- to actually make it more convenient at long last, rather than 'you should feel lucky that we see you at all,' " said
Urgent care centers typically consist of a free-standing physician office with extended hours and walk-in service. Many offer X-rays and laboratory testing, plus treatment for cuts and broken bones.
Their growth across the country follows the expansion of retail clinics, which offer a more limited set of medical services in pharmacies, grocery stores and discount outlets. In 2010, researchers at the
"It's a fraction of the cost," said Dr.
Centers are open from
MedExpress plans 12 locations in
"For something as simple as a strep test, it's easier to just get it over and done with," said
Hospitals and traditional clinic operators say they're making care more convenient, too.
Hospital and clinic operators draw a distinction between the urgent care centers they operate, and those run by independent groups like MedExpress -- particularly if they use a different electronic medical record system.
"These kind of urgent cares could add a layer of headache for consumers/patients with respect to care coordination,"
Independent centers could add to health care costs by ordering tests and providing services that patients don't need, said Dr.
"Unless you can say there's an unmet need, 12 more urgent cares is going to simply add cost," he said.
Urgent care works well when it's connected to other providers that can provide good follow-up care, said
Brandt argues that independent urgent cares don't have the overhead costs that come with caring for patients over the long run.
"They're taking the easy stuff, which is how they make money," he said.
Starcher, the MedExpress official, said his company wants to work with primary care providers. MedExpress physicians obtain a thorough health history that prevents duplicative services and work to connect patients with needed follow-up care, he said.
MedExpress doesn't use the electronic health record software used by most health systems in
Independent urgent cares might complicate the goal of traditional health care providers coordinating patient care for efficiency, said Pauly, the health economist at the
One of the first big markets for MedExpress was
Despite all the competition, the company was able to profitably open roughly a dozen centers in that area, plus many more across the state.
"I think they're taking some of the pie," Foreman said, "but I do think they're probably growing it, too."
From a cost perspective, there's often concern that health care expansions inevitably drive more demand.
In March, for example, RAND researchers published a study suggesting that retail clinics actually added costs, because they made it easier for people to use more care. Urgent cares weren't part of the analysis.
For now, it's understandable why competitors might view the new centers as "skimming" business, said
"It was one thing when this was covered by your insurance, and your insurance said, 'You should go to this location,' " Charland said. "If it's now coming out of my pocket, I'm going to shop around."
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