Urgent Care Review
As the population ages, the need for Emergency and Urgent Care also grows. The current physician shortage in the United States is expected to worsen over time. Other issues are affecting this shortage as well, including the shrinking economy and the impending health care reform.
Primary Care Shortage leads to Urgent Care Physician shortage
According to a press release by the Medicare Payment Advisory Commission, Urgent Care physicians will have plenty of work available from Medicare, but they may not want it. Medicare pays lower fees than private insurance so Primary Care physicians are much less likely to take on new Medicare patients. As a result, up to a third of all Medicare patients may not be able to find a Primary Care physician at all.
Some areas are hit harder than others by these statistics, such as Arizona. In some areas of the desert state, Primary Care physician-to-patient ratio is less than 6 doctors per 10,000 residents, according to a study by St. Lukes. The result of more people not having access to primary care will be increased use of Emergency Room and Urgent Care centers. Naturally, Emergency and Urgent Care physicians are going to have their hands full if this trend continues.
Weakened Economy results in Crowded Clinics
As the weakening economy runs its course; many people are losing availability to affordable health benefits. Insurance policies are lapsing at an alarming rate, and citizens receiving COBRA (Consolidated Omnibus Budget Reconciliation Act) coverage are also running out of options. With the walls closing in on affordable healthcare, many people have decided they must do without proper preventative doctor visits. As you might expect, when the severity of the condition can no longer be quelled with rest and over the counter remedies, and starts to dramatically interfere with daily life, the emergency room may be the last place to turn to. Through the stock market crash, the housing bust, and record breaking unemployment records, emergency rooms and Urgent Care clinics are filling up faster than ever.
Baby Boomers in the ER
Another factor in the insurgence of Emergency Medicine and Urgent Care cases in the United States is due to another socioeconomic group that cannot be ignored. The baby boomers will result in an exponential increase of the 65 and older demographic. This group statistically requires considerably more assets, personnel, specialists, and physician care. They need hospital and Emergency room services more and more often than any other age group.
Can Health Care Reform Solve ER problems?
Whether the health reform will crush us or not is neither here nor there. Although it has passed and been signed into law, the major changes are not set to go into full effect until 2014. The repercussions of said reform may not be fully comprehensive for years after that. Emergency room overcrowding is a serious problem, given the rising number of geriatric patients, uninsured patients, and underinsured patients. If the health care reform doesn’t fix the problems it promises, then the problems cannot be expected to get better. Emergency room overcrowding is no new issue. Health care reform should address is the loss of emergency room facilities. Between 1993 and 2003, the United States lost over 400 Emergency room facilities. What can uninsured/underinsured patients do? Besides hoping that an ambulance can get them or their loved ones to an Emergency room in time, they can do very little. In that same time frame, 1993-2003, Emergency room visits dramatically increased by over 25%. Doctors in these situations will definitely have their work cut out for them.
Even with the health bill finally signed into law its effect on our health care is not known. By 2014 their will be an increase in the enrollment into health care insurance programs. This increase when, combined with the long term aging of the population, should push demand for services and therefore cost higher. However, no one yet knows what will happen to reimbursement rates from Medicare and this new program. The question is will there be rate a cut of reimbursement rates for different specialties by Medicare and this new program that may conversely become a decreasing factor of the income of all specialties including Emergency Medicine & Urgent Care, their related specialties, and subspecialties.