Consumer demand drives boom in urgent care centers, study finds

Consumers looking for quick, convenient care are driving a boom in urgent care centers in the United States, a study has found.1

However, the centers primarily serve well off, insured patients with few providing care in underserved areas, the study showed.

Over the past two decades more than 9000 urgent care centers have opened across the country, offering care on a walk-in basis for common acute ailments and minor injuries during business hours, in the evenings, and at weekends. But relatively little is known about their effect on costs and the quality of care.

In the qualitative study, researchers at the Center for Studying Health System Change, a non-partisan health policy research institute, focused on six communities where there has been a high penetration of urgent care centers: Detroit, Michigan; Jacksonville, Florida; Minneapolis, Minnesota; Phoenix, Arizona; Raleigh-Durham, North Carolina; and San Francisco, California.

They found that the growth in urgent care was “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.”

The researchers found that centers tended to be located in higher income areas, particularly suburbs with a high concentration of people with employer sponsored insurance, a younger population, or a rapidly growing population.

Unlike emergency departments, urgent care centers are not required by law to evaluate and provide emergency services regardless of a patient’s ability to pay. As a result, the researchers said, they tend not to provide care to low income populations and few participate in Medicaid, which pays less for care. Centers also typically require upfront payment, which, the researchers noted, can be a barrier for low income patients.

The researchers said that it was unclear whether the centers saved money, adding that while they may divert patients away from higher cost emergency room care, they may also draw them away from lower cost primary care practices.

They said that because the centers tended to be staffed with providers from the existing pool of primary care physicians, their possible role in addressing the growing primary care shortage in the US was also unclear.

The researchers did not find that the centers disrupted continuity of care, as some feared, because they primarily provide care for simple, acute problems rather than complex, chronic conditions that require more coordination.

But they said that as more hospitals set up their own centers or affiliate with existing ones, urgent care centers may be able to treat patients with more complex problems effectively by coordinating their care with their primary care providers through the hospitals’ electronic health record systems.

While independent urgent care center operators have little incentive to open in low income areas, the researchers noted that hospitals serving such areas may find urgent care centers to be a less expensive way of providing care to poor and uninsured patients than in their emergency rooms.

The study’s authors said, “Alternatively, if Medicaid managed care plans can justify higher payment rates for [urgent care centers] as way to control [emergency department] use, independent [urgent care centers] may be more willing to participate in Medicaid and serve areas with many Medicaid patients.”