URGENT CARE CENTERS AND THE RESPONSE TO COVID-19
Urgent care centers (UCCs) provide walk-in medical care for patients presenting with non life-threatening illnesses and injuries. UCCs typically have extended hours and are frequently open during the weekends and holidays when other primary and specialty healthcare practices are closed. Because of the accessibility of urgent care centers and the wide scope of care provided, UCCs are frequently the first point of care for individuals with urgent healthcare needs that are not able to obtain care from primary care providers and do not present to the emergency department. COVID-19 presented many challenges to preexisting healthcare delivery methods and forced Urgent Care providers to rapidly adapt and evolve their processes in order to properly meet the unprecedented needs triggered by the pandemic.
In March 2019, large urban areas of the United States became the epicenter of the COVID-19 pandemic, shortly followed by the rest of the country. At that time most primary care medical practices abruptly shut down or greatly limited patient access to care, however UCCs made a concerted effort to remain open, understanding that there would be an increasing need for access to acute healthcare services and that hospital based care was unable to meet this demand. The dedication of UC health care providers and staff allowed urgent care in the northeast to continue to provide high quality acute health care to hundreds of thousands through the crisis – a need and an accomplishment unmet by any other outpatient medical specialty.
Throughout these difficult times, urgent care operators quickly adapted to the changes in regulation concerning COVID-19 testing and delivery of care in order to meet the needs of patients and their community. Often confronted with ever changing information regarding transmission of COVID-19 and plagued by lack of adequate personal protective equipment, urgent care centers continued to operate. When officials voiced the imperative need to test as many people as possible to identify the carriers of COVID-19, the capacity to provide this necessary testing didn’t exist. Many urgent care practices, by nature quick to pivot and act, rose to the challenge and innovated to meet this need through the provision of drive-through testing, Telehealth appointments as well as whatever other means were necessary in order to continue to provide care during this crisis.
REIMBURSEMENT OF COVID-19 TESTING AND SERVICES PROVIDED DURING THE PANDEMIC
A Public Health Emergency was declared by the Secretary of Health and Human Services, under section 319 of the Public Health Service Act, on January 31, 2020 due to a rapidly evolving awareness of and concerns regarding the transmission of the novel SARS-CoV-2 virus. Emergency Departments and hospitals were quickly overwhelmed with the number of individuals presenting for care and lacked the capacity to assume this additional case load. However, many UCCs recognized the need for COVID-19 testing and treatment and quickly pivoted to source testing kits and acquired PPE to meet the public need. Many UCCs were overwhelmed by lack of access to PPE, lack of adequate staffing, and lack of guidance, however they were forced to rapidly shift delivery models and find innovative solutions to satisfy the public need for access to urgent health care, all while maintaining a safe environment for employees and the public as well as business viability.
URGENT CARE AND BILLING COMPANIES ADAPT TO A SHIFTING PARADIGM TO STAY ABREAST OF FREQUENT CODING CHANGES
In March 2020, the Families First Coronavirus Response Act (FFCRA) and the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) were enacted by the United States government. These acts, in part, mandated that health insurance providers cover services related to the detection or diagnosis of COVID-19. FFCRA further provided that insurers must provide this coverage without prior authorization or medical management requirements. These mandates, which were frequently amended, were confusing for healthcare providers, and left considerable information open to interpretation. Due to the lack of clear guidance, UCCs adopted varying approaches in order to attempt to successfully provide services while working within the framework set forth by this legislation. This experience underscores the critical role of UCCs in the provision of healthcare during a public health crisis, and highlights the ability of UCCs to pivot quickly and find innovative solutions in the delivery of healthcare during a public health crisis.
UCCss have been quick to recognize and adapt to the changing needs of their communities.
UCCs have the capacity to rapidly and efficiently provide high quality testing for COVID-19 as well as a variety of other medical conditions.
UCCs have continuously provided high quality and safe medical care throughout the pandemic despite having to deal with the unique challenges of COVID-19.
UCCs have provided a safety-valve for overwhelmed hospital emergency departments.
UCCs continue to provide care despite ever-changing regulatory guidance and without the benefit of public funding.
As response to the pandemic moves into its next phase, our partners in the health insurance industry should look forward and avoid punishing those who worked tirelessly to maintain continuity to a healthcare system during a national crisis, by either cutting or clawing back on reimbursements relating to COVID-19 testing and diagnosis. Rather, we should use the lessons taught by the pandemic as an opportunity to strengthen the relationship between UCCs, insurance payors, hospital systems and healthcare officials. As each entity is an integral component of our healthcare delivery system, it is imperative that we use this as an opportunity to work collaboratively in order to meet our ever-changing public health needs.
