If what had happened in Massachusetts also is happening in Westchester and Fairfield counties, and there’s every indication it is, there can be no doubt that we’re experiencing a growing health care revolution.A report by the Massachusetts Health Policy Commission states that since 2010, the number of urgent care centers in that state has increased more than 700 percent, from only 18 at the beginning of the decade to 145 in 2018. The Massachusetts report states that the trend has resulted in enormous cost savings, with the average cost of visiting an urgent care center coming in at $149 with a patient copay of $33, compared with a visit to a hospital emergency room costing just under $900 on average with a patient copay of $118.
Urgent care centers offer patients a way to have medical problems diagnosed and treated without having to make an appointment for a future office visit with a physician or going to a hospital emergency room for a condition which may be serious, but is not acute.
New York City has embarked on a program to open urgent care clinics within city hospitals. The first two opened in 2018 at the city’s hospital in Elmhurst, Queens, and Lincoln Hospital in the Bronx. A third is due to open in March at Jacobi Hospital, also in the Bronx. Israel Rocha, a vice president of NYC Health + Hospitals, said, “The urgent care centers will increase access to care, connect patients who don’t have a regular doctor to primary care, and help fill the gap between primary care and emergency services, while helping us achieve health care savings through a reduction in low acuity emergency department visits.”
Urgent care centers have won acceptance in several Westchester and Fairfield communities and more will be on the way if the plans of operators such as the Westmed Medical Group come to fruition. Westmed has six urgent care centers which are open seven days a week and a seventh, billed as providing immediate care services. It is open Monday through Friday.
“I would love to double (the number of centers) in the next few years,” Anthony Viceroy, Westmed’s CEO, told the Business Journal. “We look at everything as part of our business strategy annually and adjust it accordingly throughout the year.”
Westmed operates urgent care centers in Greenwich, New Rochelle, Rye, White Plains and two in Yonkers. The center offering immediate care services is in Stamford. Westmed is not alone in the marketplace. Just a sampling: MD Urgent Care operates in Mamaroneck and White Plains; CityMD, which has more than 100 locations nationwide, is in Yonkers and White Plains; American Family Care operates as AFC Urgent Care in various communities, including Fairfield, Bridgeport and three locations in Danbury; the Urgent Care Walk-In Center Fairfield is operated by St. Vincent’s Medical Center.
The Urgent Care Association of America estimated there were more than 8,200 urgent care centers nationwide in 2018, up from 7,639 counted in June of 2017. And there could be a dramatic surge in the number of centers if CVS Health, which has about 10,000 stores around the country, decides to enter the urgent care field. Walgreens has been running test locations with MedExpress, owned by United Health Group.
Viceroy said that the basic philosophy driving Westmed’s expansion into urgent care was a desire to offer the latest and most comprehensive services to patients.
“For nonacute emergencies urgent care really offers you a lot more flexibility, more convenience, still top-quality care, but in a more-timely manner.” He said Westmed’s urgent care centers offer a full range of lab and imaging services on premises and urgent care physicians have access to all medical records on file for Westmed’s regular patients.
“By having the whole patient’s history at their fingertips, they can really understand that history and make the proper diagnoses accurately the first time and get them the care that they need. Without the medical records, you really can’t make a full diagnosis because you don’t have a patient’s history.” Viceroy noted that not having a patient’s medical history on file can be a drawback at hospital emergency rooms and it takes time and effort to gather needed information.
“We really don’t see ourselves as competitive to the hospital,” Viceroy said. “In many ways, we see the hospital as a natural partner.”
Viceroy said urgent care personnel are skilled at quickly recognizing acute situations, such as heart attack or stroke. “If a patient really needs to go to the emergency room, we would call 911 and have the ambulance come and transport them to the hospital,” he said. “Every patient is treated as unique, so it’s not on a cookie-cutter basis. Overwhelmingly, the majority of visits are treated within our urgent care center.”
At Westmed, urgent care patients who need additional services often can receive them the same day. “They could get their blood work done then and there. If they need a CAT scan, they can get that the same day. If there needs to be a referral to, say, a neurologist, urgent care personnel could get them an appointment for the same day. I think that kind of convenience, coupled with the care, is really the secret sauce of Westmed,” Viceroy said.
He told the Business Journal that Westmed has grown 20 percent a year for the past 20 years. “We’re focused on ensuring that we’re taking a hard look at patients who are sick with chronic diseases. How do we better manage them? Older patients who have multiple illnesses: how do we treat them better? We take the best-in-class technology and we leverage that,” Viceroy said.
Although he did not yet have final figures for 2018, Viceroy estimated that there were 100,000 patient visits to Westmed urgent care centers during the year. If the differential in urgent care versus emergency room costs reported by Massachusetts did not vary and was applicable to all of those Westmed visits, the cost savings to the health care system from those 100,000 patients not having to go to emergency rooms might come to $75,100,000.