From app.com by Michael L. Diamond, @mdiamondapp September 19, 2014
It has taken 30 years, but Family First Urgent Care in Ocean Township finally has captured the attention of the Shore’s health care industry.
More than 16,000 patients a year are coming through the doors, many during nights and weekends. Hospital executives have paid visits, seeking partnerships. And Dr. Richard Mojares, whose father founded the business in 1981, is preparing to expand.
“I think we’re going to be able to redefine or transform the access to care,” said Mojares, the center’s medical director.
Urgent care centers are popping up at the Jersey Shore in a change that could upend how consumers get health care. Billed as more accessible than primary care doctors and less expensive than emergency room visits, the centers are quickly finding their place in the age of Obamacare.
To ailing patients frustrated with their physician’s limited office hours or their hospital’s lengthy emergency room wait times, urgent care centers are what the doctor ordered.
Cost of convenience
But the medical community is watching intently. The idea of health care on demand could pose a threat to health reform’s other goal: to coordinate care for patients so that they won’t use the system as much.
“The issue is, when people have this new convenient option that pops up, are they going to use care when they otherwise would stay home,” said Ateev Mehrotra, a policy analyst at Rand Corp., and a professor at Harvard Medical School.
It was convenient for Thelma Bubadias. The 83-year-old Neptune resident on one recent Sunday tried to pick up her startled Doberman pinscher, who responded by biting her so deeply that she required stitches. Bubadias’ daughter, Deborah Carbone, bypassed the hospital and took her to Family First instead.
“I think it’s great,” Bubadias said, while waiting for the stitches to be removed. “The fact that this facility was open. I didn’t want to go to the emergency room at a hospital. It’s four or five hours by the time you get out of there. I don’t like the waiting.”
Urgent care centers are filling a gap for consumers who couldn’t get to their doctor during normal office hours and aren’t sick or injured enough to warrant a visit to the emergency department.
Family First, for example, is open on nights and weekends, setting itself apart from primary care doctors who operate only during the week. It is equipped with IV fluids, casting material, sutures, braces and other medicine and devices that patients would find in the emergency room. But patients don’t have the waits that have come to be expected at emergency rooms, Mojares said.
And they are coming to neighborhood near you.
More are coming
Meridian Health, the Shore’s biggest hospital network, has acquired four urgent care centers this year. MedExpress, a Canonsburg, Pennsylvania-based company that specializes in urgent care centers, opened a facility in Hazlet in March. Integrated Medicine Alliance, a physicians’ group, operates three walk-in clinics in Monmouth County. And even retailers such as CVS have brought on nurse practitioners to treat patients.
“The object is to try to create and deliver a … system where people have access as close as possible,” said Richard Mackesy, vice president of strategic planning and development for CentraState Healthcare System in Freehold Township, which also is searching for urgent care partners.
What’s driving the shift?
- • The Affordable Care Act, or Obamacare.
- The law mandates that nearly everyone have health insurance. More consumers with insurance could create a strain on primary care doctors’ offices – and a demand from patients unable to wait for an opening in their doctor’s schedule.
- • The push to keep down costs.
- Both Medicare and private insurers are trying to keep patients out of emergency rooms, where the service is more expensive. A 2010 report co-authored by Mehrotra found as many as 27 percent of visits to hospital emergency rooms weren’t, in fact, emergencies, costing $4.4 billion a year.
- • Consumers have grown accustomed to finding service around the clock.
- They can shop at the mall or withdraw money from ATMs on nights and weekends. Why can’t they see a doctor?
“We’re an on-demand society,” said Dean Lin, president of Ocean Medical Center in Brick. “You see that in other aspects of society, and now it’s coming to health care.”
Still, urgent care centers could be a wrench in another of Obamacare’s goals: putting the brakes on health care costs. The system is relying on primary care doctors to be something of a coach, guiding patients to better health over a long period of time. What happens if patients skip from doctor to doctor every time they get sick?
And most illnesses simply take time to run their course – with or without a visit to the doctor. But patients might stop in at a neighborhood urgent care clinic just to be safe, Mehrotra said.
“Most problems would have gotten better anyway,” he said. “It’s something I’m concerned about. There’s an assumption these are saving tons of money, but a lot of people could go there.”
Mojares doesn’t see a downside. He said he can help patients quickly, easing the burden on primary care doctors and emergency rooms. He keeps patients’ primary care physicians notified of his treatment. And he plans to expand, noting there should be room in the market for several more clinics.
“In New Jersey, we’re a little behind the eight ball, but I think we’re really going to make health care accessible to all the citizens,” Mojares said.
Shore seniors lose doctors because of contract fight
Michael L. Diamond; 732-643-4038; email@example.com