From Fall 2014 issue of For Your Benefit newsletter pdf format of fybfall2014state.pdf

The GIC’s Centered Care Initiative continues to make strides in how health care is delivered.  In the last couple of issues of our For Your Benefit newsletter we’ve highlighted the first four elements of Centered Care:

  1. Primary Care Provider (PCP) identification
  2. PCP engagement
  3. Data sharing
  4. Low cost providers encouraged

The fifth element, Expanded Hours and Urgent Care Access, is helping to improve access to care when patients need it.  According to a recent UniCare survey, the number of Massachusetts PCP practices offering expanded hours is increasing.  One quarter of practices hold evening hours and 30% offer weekend hours. 

Expanded hours benefit patients and providers:

  • Improves convenience of getting care and increases patient satisfaction (especially for working and single parents).
  • Better care coordination: The practice has access to all of the patient’s medical records instead of relying on an Emergency Room to transfer a visit report.
  • Improved quality: With access to the patient’s medical records, the practice is better able to target appropriate tests; less likely to order unnecessary test or overprescribe medications.
  • Lower costs for members and higher income to practices:  The average Emergency Room charge for three common reasons for an ER visit (middle ear infection, pharyngitis, and urinary tract infection) is $570 and only $155 at an Urgent Care facility according to a 2007 Annals of Internal Medicine study.  Patients have lower copays when visiting their doctor or doctor’s urgent care facility and the PCP practice is paid for the visit instead of a hospital.
  • Reduced wait times:  The average ER visit wait time is 56 minutes according to the Centers for Disease Control, with much greater waits during certain times and days of the week.  One third to one-half of all ER visits are for non-urgent care according the National Hospital Ambulatory Medicare Care survey.  If more patients have access to extended hours and urgent care, the wait time at the ERs will go down for those who need the ER.

Practices are also taking a look at expanding their hours to help spread fixed costs, improve patient scheduling, offer alternate hours for physicians and other staff members, and improve the use of their facilities.

The bottom line:  expanding hours is a win-win for everyone. 

This information provided by the Group Insurance Commission.