Hospitals Claim They’re Losing Insured Patients to Urgent Care

When you are sick or hurt you want to get quality care soon as possible so you can start to feel better. Usually, we go to our primary doctors and health care providers when we are sick. However, this is not always an option when there are no appointments available or the office is closed. This is where walk in urgent care services can make a world of difference. Rather than worrying over things like how far is the nearest hospital, will there be a long wait, how many people will be in the waiting area, and can I afford a hospital trip- you can focus on getting seen quickly. Instead of heading to the ER and having to spend time in the emergency room around a bunch of people for hours on end just to be seen, heading to a walk-in urgent care center can get you the same type of care but without the long waits usually. If you need urgent care and are asking yourself ‘Is the urgent care open today?’ a quick online search should pull up local clinics where you can check their hours of operation before you head out.

An increasing numbers of patients in Texas are choosing to receive medical treatment at local urgent care clinics, as opposed to experiencing long waits in hospital emergency rooms. Urgent care clinics continue to pop up in area strip malls and plazas, and have become one of the fastest growing segments in the American healthcare industry.

Urgent care facilities promote themselves as having faster and cheaper medical treatment options than hospital, and cater to patients by offering an array of services, including stitches, x-rays, and treatment of allergic reactions. Many clinics have been around for years, however, a recent boom in the industry results in nearly 300 clinics opening each year.

However, the rapidly increasing number is troublesome for Texas hospitals, who claim they are competing with clinics for the very same group of insured patients. This is especially problematic as hospitals are receiving less money to cover the cost of treating those who are uninsured.

Urgent care centers may be at an advantage, as they can only treat those who are insured or who can afford to pay for their own care. However, the clinics usually do not accept Medicaid. In comparison, hospitals are required to treat every patient in their emergency department, regardless of their ability to pay. Additionally, urgent care providers claim they are aiming to expand access to emergency-like treatment and care, while also alleviating long hospital emergency room wait times, especially for patients who are suffering from non-life threatening conditions.

“Hospitals are technically competition for urgent care centers however emergency departments (ED’s) are meant to serve patients with true emergencies and not those with minor and manageable medical issues,” says Alison Hare, Practice Administrator AFC/Doctors Express Urgent Care. “In theory, urgent care centers are meant to do two things; One, help alleviate the work load of local ED’s so they can treat high level medical emergencies and two, provide patients access to affordable and quality care for their non-emergent medical needs.”

Texas has approximately six million uninsured residents, and unpaid emergency room bills contribute a staggering $5 billion in uncompensated costs, which the Texas Hospital Association estimates hospitals are left with each year. This legal responsibility may be a financial liability for hospitals grappling with low reimbursement rates from the government, compounded by uncompensated care costs.

The Urgent Care Association states there are 435 urgent care centers in the state of Texas, compared to 450 hospitals. This increased competition for patients comes at a time when hospitals are experiencing additional cuts under Affordable Care Act guidelines.

In an effort to fund the expansion of Medicaid under the new health care reform laws, the federal government is reducing payments to hospitals for uncompensated care. However, Texas has declined to expand Medicaid in order to provide coverage of low-income adults, resulting in hospitals having less money to treat the same uninsured population.

Now, more than ever, patients have several options in which to seek treatment.


Leave a Reply

Your email address will not be published. Required fields are marked *