Archives     Advertise     Editorial Calendar     Subscribe     Contact Us    

Urgent Care Association Publishes Official Position Statement Regarding Payer Reimbursement


The Urgent Care Association (UCA) has published an official position statement regarding payer reimbursement explaining how urgent care centers (UCCs) play an essential role in the delivery of non-emergent and primary care services to consumers across the country, and deserve fair reimbursement for the service and access provided. The arbitrary restrictions placed on the scope of services provided and follow-up care are not in the best interest of the patient's health and limit clinicians' ability to provide care consistent with clinical best practices.

"Urgent care centers provide many of the same services offered by primary care providers (PCPs), yet the disparity in co-payments creates disincentives for patients to seek needed care," said Laurel Stoimenoff, CEO of UCA. "Plan designs should align co-payments with those offered by traditional PCPs."

According to 2016 data reported by the Centers for Disease Control and Prevention (CDC) National Ambulatory Medical Care Survey (NAMCS), 85.1% of adults and 93.6% of children within the United States visited a health care professional during the year. Outpatient physician office visits were reported as follows:

  • Number of visits: 883.7 million
  • Number of visits per 100 persons: 277.9
  • Percent of visits made to primary care physicians: 54.5%

From this data, the UCA 2018 Benchmarking Report of median daily patient volume and the UCA's database of U.S.-based urgent care centers, it is estimated that urgent care represents more than 24% of all primary care visits and 13.4% of all outpatient physician visits.

"Our members are telling us that arbitrary contractual barriers are limiting them from acting in the best interest of their patients," said Stoimenoff. "As an example, many patients seek care in the urgent care center when traveling, yet some contracts deny any follow-up care which makes no sense. There seems to be an assumption that everyone has a PCP or they have ready access to their PCP. When the practice of good medicine is at risk, we need to speak up."

UCA Position on Reimbursement Will Favorably Impact Population Health

Urgent care centers typically offer medical evaluations, treatment and diagnostic services, including onsite radiology and laboratory, rendering them one of the highest value locations to deliver care to consumers; yet, payer contracts oftentimes restrict the scope of practice of UCCs and deny payment for wellness and other services not directly deemed an illness or injury. These restrictive practices fail to consider that 35% of patients seeking care in a UCC are unaffiliated with a primary care physician (PCP) or medical home.

"The Association of American Medical Colleges (AAMC) predicts a huge shortfall of primary care physicians by 2030," said Stoimenoff. "Urgent care centers provide and will continue to deliver a significant amount of the primary care in the country and support PCP practices through easy access to same-day care and collaboration."

To view the full position statement, along with other position statements that have been published by UCA, please


Related Articles:

Recent Articles

AHA's Maryjane Wurth To Retire In 2020; Michelle Hood To Join The Association

Maryjane Wurth, the American Hospital Association's (AHA) executive vice president and chief operating officer (COO), will retire next year after a long and distinguished career in the hospital association field.

Read More

Tennessee Sees Fewer Infant Deaths In 2018

Infant Mortality Data Dashboard Now Available

Read More

Amedisys Expanding Commitment to End-of-Life Care for Veterans

Third Largest Hospice Provider Cared for 5,540 Dying Veterans Last Year

Read More

AMA Applauds Relief from Documentation Burden in New Medicare Rule

Many physicians will have reduced documentation beginning in 2021

Read More

Oncology Innovation in Nashville

From personalized medicine to innovation in GI care, Middle Tennessee oncology leaders share promising news.

Read More

Critical Insights into Nashville Health

For the first time in nearly two decades, Nashville has a countywide assessment providing insights into the health and well-being of the community.

Read More

Physician Spotlight: Leading with Compassion

Hospice care is so much more than simply pain management. Compassus CMO Dr. Kurt Merkelz focuses on helping patients live fully until the end.

Read More

The Oncology Care Model Value Proposition

The American Journal of Managed Care® hosts meetings across the country to help oncology practices understand and navigate the value-based care landscape at the intersection of quality and efficiency.

Read More

Tennessee Falling Short on Cancer-Fighting Public Policies

A 2019 ACS CAN report shows the state is falling short on public policies to fight cancer.

Read More

ONcology Rounds

Middle Tennessee's robust oncology programs are tackling cancer on numerous fronts.

Read More

Email Print



Powered by Bondware
News Publishing Software

The browser you are using is outdated!

You may not be getting all you can out of your browsing experience
and may be open to security risks!

Consider upgrading to the latest version of your browser or choose on below: