What's going on with all of the CityMD/Premium Care/Urgent Care facilities that are popping up?

[Renew Deal]

There are lots of medical clinics popping up in the NY/NJ Metro area. They seem to be coming from a group called City MD. Is there a reason why these are popping up? Is it simply patient convenience, or is it related to effects of the ACA, or is it something else? Are these places popping up in other parts of the country?

Why CityMD?

CityMD Urgent Care values convenience, quality of service, and superior medical care. With several locations in Manhattan, Brooklyn, Queens, Long Island, Westchester and Rockland County, we are always there when you need us. Our highly trained staff uses electronic medical records and electronic pharmaceutical transactions, and our board-certified emergency medical physicians will see you quickly, then they take the time to give you the right diagnosis, answer your questions, and set up the aftercare you need. We want you feeling better when you leave.

http://www.citymd.com/about

http://www.citymd.com

[Jester Messiah]

1. Everybody's got insurance now.

That means there's more insurance money to be had, hence you see places like this popping up. What's interesting is that, in my recent open enrollment materials, we were encouraged to consider urgent care facilities over "costly" emergency room visits. I'm getting a bad feeling that these are going to be the payday lenders of medical care though.

[Renew Deal]

3. More customers makes sense

I was thinking about that too. I guess a small percentage difference in the number of people covered is still a lot of people. Also better coverage will have people seeking more services.

I've dealt with one of these facilities in the past and it's convenient because they take a regular co-pay and it's not considered a hospital visit.

[Erich Bloodaxe BSN]

5. ER's ARE costly.

Any time I've gone to the ER, I've wound up with many hundreds of dollar to multi-thousand dollar bills, even for things that turned out to be 'false alarms'. I can hit the 'urgent care' for the cost of a doctor's office visit, and I can just do 'walk-in', not waiting weeks to get an appointment slot.

[Jester Messiah]

8. I'm just reminded of a quote from a "Street Doc" in Shadowrun

"Now let me find a needle, and not TOO rusty! Heh heh! Just kiddin'."

I fear that these Urgent Care practices won't have to meet the same level of regulation as hospitals or other doctor offices. I dunno, maybe that fear is unfounded, but I'm getting a shady vibe.

[brooklynite]

10. I know local hospitals that run urgent care centers as well...

It's a new way to package basic medical services without the annoyance of waiting weeks for an appointment.

[jwirr]

12. One of our local hospitals had this years ago.

[hobbit709]

2. M-O-N-E-Y!

[Renew Deal]

4. Who's money?

[hobbit709]

6. From your pocket to theirs.

[NCTraveler]

7. I don't have a good answer for you but did notice them "growing" before the ACA.

They have been popping up in the bay area for around ten years not. Popping up at an amazing rate. BayCare is also taking over the local industry.

[jen63]

9. Give me an Urgent Care

instead of an ER any day! For not so serious injury, or illness, they are the best. Wait times are shorter and broken bones, and other non life threatening illnesses are taken care of pretty damn quick.

The only time I ever took my son to the ER was for MRSA and a dog attack, requiring 100 stitches. Everything else Urgent Care can handle. It's also quite a bit cheaper, at least for my insurance plan. ER visits are automatically $100 out of pocket. Urgent Care cost me nothing.

[TreasonousBastard]

11. I suspect it has a lot to do with the trend for doctors to...

group together to save on expenses. Apparently, running a family practice the old fashioned way is a sure way for doctors to go broke.

I signed up for one of those close to home when I went on Medicare, but found out that the doctor listed on the sign was never around. They did tests and some other stuff, but I have no idea what happens if you are really sick or injured.

[Renew Deal]

13. Years ago I had to pick a primary care physician.

I picked someone off a list that worked in a clinic. I don't think I ever met that doctor.

[sufrommich]

14. The greatest generational boom in this country is aging.

It's always been predicted that health care facilities would grow along with aging baby boomers.

[Raine1967]

15. A lot of it (most of it) is because of the ACA:

http://www.hhs.gov/healthcare/facts/blog/2014/06/expand-services-at-community-health-centers.html

Health centers are an essential part of the U.S. health system. In small towns and in cities, in every state across the nation, they help prevent and treat illness and help people with chronic health problems. Today, I want to tell you about a new investment in health centers that will allow them to reach even more people than the 21 million they currently serve. As a result of the Affordable Care Act, the Health Resources and Services Administration (HRSA), is announcing the availability of $300 million to help the nation’s community health centers continue to expand service hours; hire more medical providers; increase availability of medical services; and add services such as oral health, behavioral health, pharmacy, and/or vision services.

HEre is some more information:

Funding for enrollment and outreach is just one of the ways the nation’s 1,200 community health centers are benefiting from the Affordable Care Act. The law also established a five-year, $11 billion Community Health Center Fund to support new construction and expanded services and operations. Much of the law’s success could depend on the ability of community health centers to engage and enroll vulnerable, underserved and hard-to-reach populations. Community health centers serve about 21 million people every year, providing culturally competent care to millions of uninsured, low-income and unemployed residents. A defining characteristic of such centers is having a governing board that includes patients as a majority of its members.

Amy Simmons Farber, director of communications at the National Association of Community Health Centers, said that about 800 communities are waiting to establish a center and 60 million Americans do not have access to primary care, largely because of where they live — both of which are problems that Affordable Care Act funding is starting to address. Still, centers face funding issues. While the Community Health Center Fund was intended as additional funding, it has recently been used to backfill declines in federal support.

It was something that Senator Sanders pushed to have put into the ACA.

[antigop]

16. NY Times: Race is on to Profit from Rise of Urgent Care

http://www.nytimes.com/2014/07/10/business/race-is-on-to-profit-from-rise-of-urgent-care.html

Instead, they have turned to one of the fastest-growing segments of American health care: urgent care, a common category of walk-in clinics with uncommon interest from Wall Street. Once derided as “Doc in a Box” medicine, urgent care has mushroomed into an estimated $14.5 billion business, as investors try to profit from the shifting landscape in health care.

The office here is part of PhysicianOne Urgent Care. Bankrolled by two private investment companies, PhysicianOne has grown into an eight-clinic operation, the largest of its kind in Connecticut, with plans for even greater expansion.

But what is happening here is also playing out across the nation, as private equity investment firms, sensing opportunity, invest billions in urgent care and related businesses. Since 2008, these investors have sunk $2.3 billion into urgent care clinics. Commercial insurance companies, regional health systems and local hospitals are also looking to buy urgent care practices or form business relationships with them.

The business model is simple: Treat many patients as quickly as possible. Urgent care is a low-margin, high-volume proposition. At PhysicianOne here, most people are in and out in about 30 minutes. The national average charge runs about $155 per patient visit. Do 30 or 35 exams a day, and the money starts to add up.

Urgent care clinics also have a crucial business advantage over traditional hospital emergency rooms in that they can cherry-pick patients. Most of these centers do not accept Medicaid and turn away the uninsured unless they pay upfront. Hospital E.R.s, by contrast, are legally obligated to treat everyone.

There's your answer.