Urgent care growing in WNC

Across the country, and in our own backyard, urgent care centers are one of the fastest-growing sectors in the health care business, providing patients with quick, convenient and less-costly alternatives to emergency room visits.

“Whether it is an after-hours situation and a patient can’t get into their primary care provider, or the patient has not yet established care with a provider, the urgent care center offers a viable, efficient, easily accessible option for care,” says Johnna Reed, chief administrative officer for Hendersonville’s Pardee UNC Health Care. Pardee currently operates two urgent care centers in Henderson County, with a third planned to open in Mills River this summer.

According to a 2012 Centers for Disease Control study, emergency department wait times averaged about 58 minutes nationally. Studies by the Urgent Care Association of America show that 65 percent of urgent care patients wait less than 20 minutes. These clinics provide services for everything from lacerations to cold and flu symptoms, ensuring that patients don’t have to wait hours, days or weeks to see a physician.

In the Asheville area, urgent care clinics are filling the gap between emergency rooms and primary care physicians. “Across the board,” says Reed, “we see an increased demand for urgent care centers.”

Where to go and when

“Mercy Urgent Care fits in between the Emergency Department and a primary care office,” says Dr. Elizabeth McCarty, medical director for Mercy Urgent Care. “The Emergency Department is best for life-threatening events that may require specialized testing or admission to the hospital, such as chest pain, head injury or possible appendicitis.”

One’s primary care provider, McCarty continues, is the best choice for managing chronic illnesses such as diabetes or hypertension.

“For acute illness or injuries,” she says, “an urgent care is the most efficient option.”

Many urgent care clinics also offer services for employers, such as drug testing, respiratory testing and pre-employment services. They also perform the physicals required by the N.C. Department of Transportation to obtain a commercial driver’s license. Additionally, the clinics provide immediate answers to health questions.

“Urgent cares provide quality care at a fraction of the time and cost of a hospital emergency department,” McCarty says. “For acute illness or injury, Mercy Urgent Care can evaluate patients that day, where they might have to wait two to three days to see their primary care physician. And Mercy UC is able to do many lab tests right in the center with an immediate answer and has X-ray facilities and technicians at every location with immediate readings. Mercy UC treats patient across the entire spectrum, from infants and children with minor illnesses to adults to workers injured on the job.”

Mercy Urgent Care operates five locations (see sidebar, “Care close to home”). [sidebar ID= “4676”]

According to a study by Accenture, visits to urgent care centers rose 19 percent from 2010 to 2015 nationwide. At Mercy Urgent Care in Asheville, officials estimate that the clinics have seen over a million patients since 1985. And according to the American Academy of Urgent Care Medicine in Orlando, Fla., the number of urgent care centers in America has grown to more than 9,000, an increase of 14 percent since 2008.

Open for business

This could be due, in part, to urgent care centers’ hours of operation. Many have extended hours and are open on weekends and some holidays. Mission Health Care’s Mission My Care Now centers in Arden and Marion, for example, are open seven days a week from 7 a.m. until 10 p.m. Urgent care centers also get patients in and out quickly, seeing patients in as little as half an hour, as opposed to hours in an emergency room setting or much longer waits for appointments with their primary care physician.

A study by Kalorama Information, a health care data information publisher in Rockville, Md., showed that on average, urgent care centers see about 294 patients a week and about 15,300 patients throughout the year. And that trend is expected to expand through 2021, with urgent care centers expected to see an estimated 300 patients per week.

“Most of the urgent care center market is related to colds, flu and throats, which will continue to represent the greatest single source of [urgent care center] revenues, followed closely by treatment of lacerations and wounds, and fractures and sprains,” says Bruce Carlson, Kalorama Information publisher, in a press release.

Another local provider, Fast Med, offers three locations in Western North Carolina. The company, which has over 100 patient facilities in North Carolina, Texas and Arizona, operates 8 a.m.-8 p.m. weekdays and 8 a.m.-4 p.m. on weekend days. An online counter displays the number of patients in line at each location in real time.

In addition to helping the patient get in and out quickly, the care centers are also focusing on their patients’ experiences once they’re inside.

Experience matters

According to Pricewaterhouse Cooper’s Health Research Institute, the “patient experience” is one of the top trends to watch in health care for 2018. “Today’s consumer is used to sophisticated shopping experiences, in which retailers harness consumer information to tailor how they interact with customers,” the institute advises.

Following suit, facilities are changing the way they offer their services to meet the needs and expectations of patients.

Mission Health now offers Mission My Care Now and Mission Virtual Clinic, which provide patients with convenient appointments, as well as online scheduling and diagnosis.

“Similar to a traditional urgent care, Mission My Care Now offers walk-in medical services with no appointment necessary,” says Dr. Courtney Mull of Mission My Care Now.

Mission My Care Now, however, differs from urgent care centers in that charges are based on the same copay as a visit with a primary care physician. Electronic health records are shared between My Care providers and the patient’s regular provider. “This allows a close, team-based approach to health care at hours convenient to the patient,” Mull explains.

This time of year, most My Care Now patients are coming in seeking treatment for colds, flu and pneumonia, as well as gastrointestinal, urinary tract and skin infections. And, Mull says, given the recent slippery weather, the clinic is seeing patients for injuries, sprains and minor fractures. Other services include helping patients with depression and anxiety, or working to immediately stabilize chronic diseases such as diabetes or hypertension.

Launched in March 2017, there are four My Care Now clinic locations: Arden, Marion, Spruce Pine and Franklin. Asked whether a recently announced $20 million inpatient facility in East Asheville (see avl.mx/4ml) will offer urgent care or walk-in services, Mission Health’s Cara Truitt responded by email, “At this time, we do not have additional information or details available to share.”

Virtual reality

Along with My Care Now, Mission Virtual Clinic offers patients access to medical diagnosis and treatment from the comfort of their home or office, or even their car. For a fee of $25, anyone in North Carolina can access the virtual clinic, using any major credit card.

“Mission Virtual Clinic is an entirely online experience that allows a patient to be seen from home, their office or any other location within North Carolina,” says Dr. Steve North with Mission Virtual Clinic. “It helps avoid long times in the waiting room and reduces the chance of diseases spreading. Any patient in North Carolina can receive care through Mission Virtual Clinic regardless of where they receive primary care. You can even use Mission Virtual Clinic from your smartphone by logging into Mission-Health.org/virtualclinic.”

The process is simple. Patients access the Mission Virtual Clinic online and answer a few questions in an online health survey. From 7 a.m. to 11 p.m. daily, patients receive an answer within an hour from a physician or advanced care practitioner. If patients access the system outside of operating hours, they can expect a response by 8 a.m. the next morning. The health care provider will give patients information on how to treat their illness and, if necessary, prescribe antibiotics or other medications. Prescriptions are ready for patients to send to their pharmacy within a couple of minutes.

“Mission Virtual Clinic is an ideal way to have cold and flu symptoms, sinus infections, skin conditions and female urinary tract symptoms evaluated and potentially treated,” North says. “For patients with possible flu or strep throat, where a rapid flu test or strep test is needed to determine the best treatment, a ‘zipticket’ may be ordered by the provider, and the patient can go to multiple Mission Health locations and have this performed without needing to be seen by a provider there.”

Patients who require further testing are referred to Mission My Care Now, where they are quickly seen and tested, avoiding the wait of a traditional appointment.

Warm welcome

At Range Urgent Care, husband-and-wife founders Dr. Stephanie and Mathew Trowbridge focus on the facility’s atmosphere and billing structure.  The couple opened the clinic on Merrimon Avenue in North Asheville in November.

“Our health care system is broken, and urgent care clinics are an important part of a solution in providing affordable and convenient access to high-quality care for our community,” says Stephanie Trowbridge. 

According to Mathew Trowbridge, Range offers an environment that’s “closer to a spa or coffee shop than the traditional sterile clinic we are all used to.” Coffee, tea and sparkling water welcome patients, who can choose to schedule their appointments in advance online, ensuring that they will be seen quickly. A flat rate of $149 covers all in-house services including X-rays, prescriptions and lab work.

“This model eliminates patient fears of receiving large medical bills in the mail following their visit and allows providers to practice according to what is best for the patient and not focus on what treatments they are allowed to bill for,” Mathew Trowbridge explains.

According to Kalorama Information’s research, costs at urgent care centers are as much as 75 percent less than those in emergency rooms for non-acute illnesses.

“Trips to the emergency department often run into the thousands with copays between $250 and $500,” Mathew Trowbridge says. “Today, people are more accountable than ever for the dollars they are spending on health care with high-deductible insurance plans, health care savings accounts and rising premium costs that leave many without insurance at all. Urgent care offers a significantly more affordable option of treatment of acute non-life-threatening conditions.”

Piece of the puzzle

But experts warn urgent care centers should not be overused. In fact, most urgent care centers work with patients to help them establish or maintain relationships with primary care physicians.

For its part, Hendersonville’s Park Ridge Health hasn’t waded as deeply into the urgent care waters as some other local providers. “We have found patients prefer the option of a true appointment rather than checking in and waiting for the next available provider,” says Christy Sneller, Park Ridge’s vice president for physician services. For unplanned health care needs, she says, Park Ridge Health offers scheduling for same-day and next-day appointments at 855-774-5433.

“Mercy Urgent Care feels urgent care works best in conjunction with the primary care doctor,” McCarty says. The Mercy clinics refer patients back to their own physician for follow up, sending copies of records, lab tests and X-rays to the doctor’s office, she explains.

“For patients that do not have a primary care provider, we maintain a list of local offices taking new patients and try to facilitate the process,” McCarty continues. Responding to urgent health care needs, she says, is just one part of the health care puzzle. “We encourage all our patients to become established with a primary care provider where they can receive regular preventative services and ongoing care.”