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Hospital Emergency Departments May Be Overrun by ACA Newly Insured [Podcast]

By Stewart Gandolf, Chief Executive Officer
Photo of Marc Salzberg

Marc Salzberg MD

In our continuing series of healthcare marketing podcasts, Dr. Marc Salzberg, President of the Board of Directors of the Urgent Care Association of America, discusses increasing public demand and other critical issues facing the urgent care industry in advance of the Affordable Care Act (ACA). Interviewed by Healthcare Success Co-Founder and Hospital Division Director Lonnie Hirsch.

Dr. Marc Salzberg is concerned that, with the launch of the Affordable Care Act, the market demand of people who previously had no access to insurance may overrun hospital emergency departments. In this podcast conversation with Lonnie Hirsch, Dr. Salzberg talks about the urgent care sector and how healthcare in general will see an increase in demand.

“The numbers are in the range of 20 to 30 million people who will suddenly have some form of insurance that they’ve never had previously,” Dr. Salzberg said, “albeit this insurance will probably be at the Medicaid level of reimbursement.

“I’m not sure how many urgent care facilities in the country will accept that form of payment, but we do know that it will have impact on hospital emergency departments, and on free clinics that will now take the Medicaid patient—but hospital emergency departments in particular.”

What’s more this market pressure is likely to create a spillover effect. Dr. Salzberg, President of the Board of Directors of the Urgent Care Association of America, indicated that “the more crowded that emergency departments get, the less desirable it will be for the mid-level patient and they will seek out facilities as an alternative.”

Urgent care facilities are growing in number, but marketing strategies vary…

Approximately 25 percent of urgent care facilities in the US are hospital owned. We see some a move toward more hospital ownership, and the continuing addition of many new urgent care centers owned by private physicians,” according to Dr. Salzberg. “Both of these groups are expanding.

“Hospitals usually put up urgent care centers to fend-off privately owned clinics and to work as feeders to the hospital. A private physician group that opens an urgent care center should do their homework before they get into the marketplace. They need to look at the demographics of the area, what the competition is, and the local hospital situation.”

The business model and the marketing strategy of an urgent care facility will vary, Dr. Salzberg said. “For example, at STAT Health we only utilize emergency medicine physicians, and we don’t use mid-level providers. [However] there are other urgent care centers in this country that are owned by primary care or family practice physicians who do primary care within their urgent care structure.”

Accounts Receivable will grow with higher deductibles…

What has happened to all practices—family practices, urgent care, internal medicine—is, with higher, $2,000, $3,000, $4,000 deductibles, there is an increase in accounts receivable,” Dr. Salzberg observed. “Patients pay their $20 or $30 co-pay, and [later] get a bill.” Although the visit is covered, when they have not yet met their deductible, it becomes the practitioner’s responsibility to collect the unpaid amount.

For more about these and other issues facing the urgent care sector, listen to Lonnie's conversation with Dr. Salzberg.

The nation’s changing healthcare delivery system and the continuing implementation of Accountable Care Act reforms will, in the view of Healthcare Success, lead to increased competition.

From a marketing perspective, highly visible urgent care facilities—those with a good story and good patient experience—will thrive. More aggressive and sophisticated marketing from health system and corporate competitors will marginalize passive and secondary urgent care clinics.

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Marc Salzberg, MD, is founder of STAT Health Walk-In Medical Centers with four locations on Long Island in the New York City area. Dr. Salzberg also serves as President of the Board of Directors of the Urgent Care Association of America and sits on the Editorial Board of The Journal of Urgent Care Medicine.

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