By Christopher Franklin
Primary care and urgent care have never been the closest of allies. Concerns about disruptions to care continuity and coordination – not to mention competition – have historically led primary care providers to be tentative about the role of urgent care centers (UCCs) in the care continuum. Yet building a strategic alliance between the two is becoming a necessity as our health needs overwhelm our primary care resources. While population health expectations shift, insurance coverage expands, care delivery models evolve, and the number of available PCPs dwindles, access to primary care services becomes increasingly constrained. At the same time, access to urgent care is ramping up. Since 2008, the number of UCCs has grown from 8,000 to about 9,300 sites across the nation. The expansion of urgent care is more indicative of the growing demand for acute care services than a competitive threat to primary care. Health systems can help ease the burden on PCPs, enhance access to care (particularly non-emergent acute care), and better meet patient demands by integrating UCCs into their primary care networks.
The Growth of America’s Aging Population
The growth of the country’s aging population is one of the factors restricting the availability of appointments with PCPs. Estimates suggest that 81% of the change in demand for health services from 2010 to 2020 will be the result of aging and population growth. And the over-65 patient population isn’t just growing – they’re also living longer and with an increased prevalence of comorbidities that require continual care. Changing reimbursement structures and initiatives are focused on effective population health management. Incorporating UCCs into primary care networks provides the opportunity to efficiently meet patients’ acute care needs while allowing PCPs to channel more of their efforts into effectively managing the health of patient populations, such as the aging population, that require comprehensive care and pose the greatest risk of hospital admissions and readmissions.
Shifting Patient Demands
Patients are evolving into healthcare consumers, and knowledgeable consumers seek out options that meet their expectations. One of these expectations is to receive acute care services in a timely manner – not in 4 days or 4 weeks. Access to care has been one of the most commonly cited issues across patient satisfaction surveys in determining why patients select and remain with a particular provider or medical group. Conversely, lack of access is a chief complaint reported by patients who switch providers. Many PCPs are reluctantly reducing the number of same-day appointments they have available, if they have them at all, in order to keep manageable schedules. It is also not uncommon for offices to close their panels to new patients altogether, further increasing the challenge of obtaining an appointment. Since appointments for acute conditions cannot be scheduled weeks in advance, UCCs can provide access to timely care for patients seeking same-day appointments, and serve as an effective tool for retaining patients.
Greater Expectations, Fewer Physicians
Estimates suggest that an additional 32 million Americans will acquire health coverage through state exchanges due to the ACA. But this influx in newly insured patients is colliding with a PCP deficit projected to grow into the tens of thousands by 2020. Not only will PCPs be scarce, but the responsibilities of those in practice will swell through PCMH initiatives. On top of providing high-quality care, physician offices will be required to demonstrate and document their ability to effectively promote patient education and self-management, complete referrals, and identify and implement evidence-based guidelines for common conditions, among other efforts. These mounting responsibilities will further hinder patients’ abilities to make appointments and establish care with a PCP, naturally turning more patients toward UCCs for acute care services.
Playing for the Same Team
The inability to provide accessible care and effectively manage the health of the population creates the potential for devastating nationwide consequences. It is becoming apparent that providing the care the population needs when they need it is a goal that primary care cannot achieve on its own. Patients will continue to gravitate toward UCCs for their acute care needs when access to primary care is restricted. Health systems, then, need to consider the opportunity in front of them and see UCCs as extensions of primary care as opposed to competition.
About Christopher Franklin
Chris works in ECG’s Healthcare Division and has extensive experience in physician practice management. This background allows him to assist clients in areas such as the strategic planning associated with medical group growth. He is also familiar with the dynamics between medical groups and affiliated hospitals and understands how to help them align their growth strategies. At ECG, Chris assists with medical group development through compensation plan redesign as well as operational and financial practice assessments. He has also supported the formation of both leadership and organizational structures to create large-scale multispecialty medical groups for health systems. Chris has a master of health administration degree from Saint Louis University School of Public Health and a bachelor of arts degree in biology from Saint Louis University.
By Christopher Franklin
Primary care and urgent care have never been the closest of allies. Concerns about disruptions to care continuity and coordination – not to mention competition – have historically led primary care providers to be tentative about the role of urgent care centers (UCCs) in the care continuum. Yet building a strategic alliance between the two is becoming a necessity as our health needs overwhelm our primary care resources. While population health expectations shift, insurance coverage expands, care delivery models evolve, and the number of available PCPs dwindles, access to primary care services becomes increasingly constrained. At the same time, access to urgent care is ramping up. Since 2008, the number of UCCs has grown from 8,000 to about 9,300 sites across the nation. The expansion of urgent care is more indicative of the growing demand for acute care services than a competitive threat to primary care. Health systems can help ease the burden on PCPs, enhance access to care (particularly non-emergent acute care), and better meet patient demands by integrating UCCs into their primary care networks.
The Growth of America’s Aging Population
The growth of the country’s aging population is one of the factors restricting the availability of appointments with PCPs. Estimates suggest that 81% of the change in demand for health services from 2010 to 2020 will be the result of aging and population growth. And the over-65 patient population isn’t just growing – they’re also living longer and with an increased prevalence of comorbidities that require continual care. Changing reimbursement structures and initiatives are focused on effective population health management. Incorporating UCCs into primary care networks provides the opportunity to efficiently meet patients’ acute care needs while allowing PCPs to channel more of their efforts into effectively managing the health of patient populations, such as the aging population, that require comprehensive care and pose the greatest risk of hospital admissions and readmissions.
Shifting Patient Demands
Patients are evolving into healthcare consumers, and knowledgeable consumers seek out options that meet their expectations. One of these expectations is to receive acute care services in a timely manner – not in 4 days or 4 weeks. Access to care has been one of the most commonly cited issues across patient satisfaction surveys in determining why patients select and remain with a particular provider or medical group. Conversely, lack of access is a chief complaint reported by patients who switch providers. Many PCPs are reluctantly reducing the number of same-day appointments they have available, if they have them at all, in order to keep manageable schedules. It is also not uncommon for offices to close their panels to new patients altogether, further increasing the challenge of obtaining an appointment. Since appointments for acute conditions cannot be scheduled weeks in advance, UCCs can provide access to timely care for patients seeking same-day appointments, and serve as an effective tool for retaining patients.
Greater Expectations, Fewer Physicians
Estimates suggest that an additional 32 million Americans will acquire health coverage through state exchanges due to the ACA. But this influx in newly insured patients is colliding with a PCP deficit projected to grow into the tens of thousands by 2020. Not only will PCPs be scarce, but the responsibilities of those in practice will swell through PCMH initiatives. On top of providing high-quality care, physician offices will be required to demonstrate and document their ability to effectively promote patient education and self-management, complete referrals, and identify and implement evidence-based guidelines for common conditions, among other efforts. These mounting responsibilities will further hinder patients’ abilities to make appointments and establish care with a PCP, naturally turning more patients toward UCCs for acute care services.
Playing for the Same Team
The inability to provide accessible care and effectively manage the health of the population creates the potential for devastating nationwide consequences. It is becoming apparent that providing the care the population needs when they need it is a goal that primary care cannot achieve on its own. Patients will continue to gravitate toward UCCs for their acute care needs when access to primary care is restricted. Health systems, then, need to consider the opportunity in front of them and see UCCs as extensions of primary care as opposed to competition.
About Christopher Franklin
Chris works in ECG’s Healthcare Division and has extensive experience in physician practice management. This background allows him to assist clients in areas such as the strategic planning associated with medical group growth. He is also familiar with the dynamics between medical groups and affiliated hospitals and understands how to help them align their growth strategies. At ECG, Chris assists with medical group development through compensation plan redesign as well as operational and financial practice assessments. He has also supported the formation of both leadership and organizational structures to create large-scale multispecialty medical groups for health systems. Chris has a master of health administration degree from Saint Louis University School of Public Health and a bachelor of arts degree in biology from Saint Louis University.
