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As monthly health insurance premiums range into a staggering four-digit payout, people who once had medical coverage are increasingly opting out. When they need care, tapping into the conventional medical network is a high-priced, out-of-pocket luxury. So walk-in centers are a godsend. They aren’t necessarily cheap: a typical consultation with a doctor runs $130 to $180; tests or procedures are additional. But it’s cheaper than an emergency room. And urgent-care centers are an option for people who are visiting from out of the area, and whose insurance doesn’t cover them.
For local folks, urgent-care centers offer affordable memberships or payment plans—another facet of customer appeal. For instance, Emergency One offers the Wellness Access Card, a membership plan with a one-time registration fee of $10 and monthly fee of $21.95 for an individual, $39.95 for a family, which can be deducted from a checking account or credit card. Patients can sign up at their first visit if they have a permanent New York state address (it’s not for seasonal visitors). The benefits of membership are discounted services: $69 for a doctor visit and 20 percent discount on laboratory services or procedures. Members can also get sports or school physicals for $25, flu shots for $20, and physical therapy visits for $45. What’s more, the Wellness Access Card is accepted nationwide by thousands of doctors, specialists, hospitals, pharmacies, dentists, vision care providers, hearing services, and more, which offer a 10-60 percent discount off their services. (An online search page allows you to find participating businesses by zip code.)
Then, there are folks who have medical insurance already. Many insurance plans (but not all) now cover urgent care visits, and consider them an office setting. So the patient pays a doctor’s office copay—typically a third to quarter of the price of an emergency room copay. Tests and other services are also covered as one’s existing health plan stipulates.
Community and Workplace Services
Urgent-care centers also provide nonemergency, ongoing medical services for companies, unions, and public agencies, from schools and fire departments to major corporations. This occupational health niche amounts to a significant portion of a center’s workload—35 percent at Emergency One, for instance. These services are things like employee physicals, workers compensation injury management, drug testing, DOT and OSHA medical screenings, physical therapy, injury prevention programs and other educational trainings, and much more. With a unique position in a community, urgent-care centers proactively court collaborative relationships with employers to design customized programs and services. Emergency One tailors employee assistance programs to provide health-related training, and even offers counseling for stress, grief, substance abuse, marital and family issues—whatever a business or agency needs to best support its workers. Emergency One’s Sports and Industrial Physical Therapy Center was developed in response to an identified need for sports and occupational health services in the Hudson Valley, and offers comprehensive programs such as evaluations of the musculo-skeletal system, gait analysis, return-to-work programs, and ergonomics education. The center usually can schedule patients for evaluation within 24 hours, or even the same day.
It’s no secret that the urgent-care sector, as it continues to flourish, stands to impact more than individual patients’ pocketbooks. The health insurance industry recognizes that most of the populace—roughly 85 percent—is healthy most of the time, according to its analysis of medical insurance usage patterns. Yet it is those same people (and sometimes their employers) who are funding the current medical insurance system. Their monthly premiums create a billion-dollar pool, which is paid out mostly to cover the skyrocketing costs of care for the chronically and seriously ill. The healthy group, by contrast, needs only episodic medical care, which is just what urgent-care centers are designed for. As the standard paradigm of health insurance or managed care gets ever more expensive, healthy people are pulling their dollars from the pool and choosing new approaches like the centers. It remains to be seen just how what’s best for the individual will have a hand in reshaping a beleaguered health insurance industry, but the transition is underway.