Enacts the "health care delivery models study act"; directs the commissioner of health to conduct a study of the current effectiveness in the delivery of health care services not presently required to undergo state certificate of need processes nor required to obtain authorization to conduct office based surgery.
TITLE OF BILL: An act in relation to directing the commissioner of health to conduct a study of the effectiveness and safety of urgent care centers and to deliver a report of the study's results to the governor, the speaker of the assembly, the minority leader of the assembly, the temporary president of the senate and the minority leader of the senate
SUMMARY OF PROVISIONS:
This Act shall be known as "The Urgent Care Center Study Act"
Section 2 of the bill states that the Commissioner of the New York State Department of Health shall conduct a study which will concentrate on the scope, effectiveness, safety and quality of care of urgent care centers along with demographic disparities in the quality of care in urgent care centers across the state.
The Commissioner of Health shall report his or her findings to the Governor, the Speaker of the Assembly, the Minority Leader of the Assembly, the Temporary President of the Senate and the Minority Leader of the Senate within one year of this legislation taking effect.
Trends in the health care marketplace, including shortages of primary care physicians in many communities and a shrinking number of hospitals and emergency rooms, have led to the proliferation of so-called Urgent Care Centers (UCCs), which are positioned as a viable alternative to traditional medical facilities. Yet the law and regulations that cover UCCs are vague at best and medical consumers are susceptible to confusion about when such facilities are an appropriate health care option. Indeed in New York, as in most states, UCCs are licensed in the same way as typical physician practices.
The "The Urgent Care Center Study Act" requires the Department of Health to conduct a study which will concentrate on the scope, effectiveness, safety and quality of care of UCCs along with demographic disparities in the quality of care in UCCs across the state. The outcome of the study will provide valuable information for health care consumers and establish whether there is a need for further regulatory action.
The growth of the urgent care sector is undeniable. The Urgent Care Association of America's (UCAOA) "2011 Urgent Care Industry Information Kit" reported the existence of approximately 8,700 UCCs in the United States, 47% of which had been operating for five years or less. The centers had an average of 342 patient visits per week and were found in all geographic settings: 25% in urban, 55% in suburban and 20% in rural locations.
According to UCAOA, UCCs "provide walk-in, extended hour access for acute illness and injury care that is either beyond the scope or availability of the typical primary care practice or retail clinic."
The American Academy of Urgent Care Medicine (AAUCM) notes on its website that "An urgent care center is a convenient option when someone's regular physician is on vacation or unable to offer a timely appointment. Or, when illness strikes outside of regular office hours, urgent care offers an alternative to waiting for hours in a hospital Emergency Room."
However, what these centers provide and how they are staffed varies. A September 2011, UCAOA-funded white paper "The Case for Urgent Care" noted that "The majority of urgent care centers provide services in episodic primary care, occupational medicine, routine immunizations and school physicals, and at least half of them (4,000+) also provide lab tests, x-rays, fracture and laceration care, and intravenous fluids." They "are typically staffed with physicians, with approximately half also employing physician assistants and nurse practitioners as additional providers."
And while UCCs are sometimes positioned as an alternative to hospital emergency rooms, as the AAUCM notes. "UCM [Urgent Care Medicine] specialists have expertise evaluating and treating these patients with only simple office-based laboratory tests (e.g., urinalysis, pregnancy test, rapid strep assay) and X-ray. There is no immediate access to extensive laboratory testing or advanced imaging (e.g., CT scanning and ultrasound). Those who present to an urgent care center who, in the judgment of the UCM specialist, require this, are transferred to a hospital emergency department."
If a patient needs to be transferred from a UCC to an emergency department he or she could lose time that is critical to his or her outcome before receiving the necessary care. Further he or she will likely be billed by both the UCC and the emergency department. And unlike hospital emergency departments, UCCs are not required by law to assess and, if necessary, stabilize everyone who arrives regardless of ability to pay.
The UCAOA-funded white paper "The Case for Urgent Care" cited studies that found the average cost of an urgent care visit is slightly less than the average primary care visit and significantly less than an emergency department visit for the same diagnosis. However, the value proposition is undermined if the patient is using urgent care in lieu of establishing a relationship with a Patient Centered Medical Home, or as noted above, if he or she presents with a condition that the UCC is not equipped to treat.
In light of inconsistencies in the services UCCs provide and the potential for confusion among health care consumers about when UCCs are the appropriate health care option, there is a clear public benefit in a Department of Health study that will both inform consumers and establish any need for further regulatory action .
This act shall take effect immediately.
STATE OF NEW YORK ________________________________________________________________________ 4493 2013-2014 Regular Sessions IN SENATE April 3, 2013 ___________Introduced by Sen. HOYLMAN -- read twice and ordered printed, and when printed to be committed to the Committee on Health AN ACT in relation to directing the commissioner of health to conduct a study of the effectiveness and safety of urgent care centers and to deliver a report of the study's results to the governor, the speaker of the assembly, the minority leader of the assembly, the temporary president of the senate and the minority leader of the senate THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. This act shall be known and may be cited as the "urgent care center study act". S 2. The commissioner of health is directed to conduct a study and do research as to the effectiveness and safety of urgent care centers. The study shall be conducted in accordance with rules, regulations and standards determined by the commissioner of health, and the study shall concentrate on the scope, effectiveness, safety and quality of care of urgent care centers along with demographic disparities in the quality of care in urgent care centers across the state. The commissioner of health shall report his or her findings to the governor, the speaker of the assembly, the minority leader of the assem- bly, the temporary president of the senate and the minority leader of the senate on or before one year from the date this act shall take effect. S 3. This act shall take effect immediately.EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD09195-03-3