March 21, 2018

Report: Use of urgent care surges in U.S.

Use of urgent care centers soared 1,725 percent from 2007 to 2016 based on private insurance claims analyzed by FAIR Health, a national independent nonprofit focused on transparency in healthcare costs and insurance information.

FAIR Health got the number examining so-called claims lines. An insurance claim line is an individual procedure listed on an insurance claim. A single claim for one patient may have multiple claim lines, so the number of insurance claim lines grew 1,725 percent during the time period studied, with rural areas showing the most gain, up 2,308 percent, while urban areas rose 1,675 percent.

FAIR Health also found significant growth in the use of retail clinics and telehealth services, "indicating the spreading acceptance and/or availability of these alternative venues of care," according to its newly published FH Healthcare Indicators and FH Medical Price Index, which will be updated annually.

FAIR Health, with a database of more than 25 billion privately billed healthcare claims, analyzed claim lines to examine trends in place of healthcare service in recent years, focusing on alternative places of services -- urgent care and retail clinics, ambulatory surgery centers (ASCs) and telehealth -- as well as emergency rooms, where claim lines rose 229 percent from 2007 to 2016.

FAIR Health also tracked growth in median procedure charges from May 2012 to May 2017 for professional evaluation and management (E&M) in and out of hospitals, medicine, surgery, pathology and radiology.

Based on the study results, different places of service are associated with different diagnoses, FAIR Health found. For example, in retail clinics and urgent care centers in 2016, acute respiratory infections, such as the common cold, were the No. 1 diagnostic category — but in telehealth, mental health-related diagnoses were No. 1.

Places of service differ in cost. In 2016, the median charge for a 30-minute new patient office visit ranged from $294 in an office to $242 in an urgent care center to $109 in a retail clinic, it said.

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