I thought urgent care facilities were for people who didn’t have insurance?

This is a common misperception. Urgent care facilities are a fast-growth market segment with roughly 8,000 centers in the United States, most of which are owned by large insurance companies, hospital systems, or physician groups. They emerged out of a consumer need to access routine healthcare services in the evenings and on weekends, and now represent a conventional part of the healthcare marketplace.

What are the advantages of urgent care facilities?

At most urgent care centers, wait times are less than 30 minutes for walk-ins, and patients are usually out the door in less than an hour. Most are open seven days a week and have evening hours, and some are even open 24 hours. Visits typically are less expensive than using your primary care physician.

But isn’t it important that I always see my primary care physician for all medical needs, even those that are not urgent?

No. Today, your primary care physician is there to assess the totality of your health and address the conditions that may be chronic or need the intervention of specialists. Routine healthcare for benign issues like seasonal colds or allergies, bee stings, swimmer’s ear, minor cuts or burns, just to name a few, are typically more readily addressed in urgent care facilities. Your records are sent automatically to your primary care physician so that the latter can maintain a complete record of your health.

Why does SWSCHP want us to use urgent care facilities?

Our perspective is that you must make your own healthcare choices that are in the best interest of you and your family. As stewards of the SWSCHP plan, the job of our Executive Director and Executive Committee is to ensure that the plan operates with a high rate of quality in a cost-effective manner. Our internal studies show that urgent care facilities are underutilized by our members, which comes at a higher cost to the plan, and may limit our benefits in subsequent years. Therefore, it is in our members’ interest to encourage greater use of these facilities.

How is this connected to ER care?

It really isn’t. If a member is experiencing an emergency (as defined above), the ER should be used. Our purpose here is to encourage an understanding that ER care – which is the most expensive immediate care provided to members– should strictly be used for emergencies. Use of the ER for events that are not deemed medically necessary will bring substantial cost to an individual member.