Massachusetts Supports Urgent Care Through Mandate to Alleviate ER Burden: Grassroots Advocacy Key to Success

Faced with overwhelming patient volumes at hospitals in eastern Massachusetts, the state Department of Public Health (DPH) launched an initiative Wednesday to relieve pressure on overwhelmed Emergency Departments by diverting patients to Urgent Care centers. This move underscores the critical role of grassroots Urgent Care Advocacy in transforming healthcare delivery and highlights the importance of community involvement in supporting UCA chapters and donating to federal Advocacy efforts.

Through the end of September, the state’s health insurers will cover treatment at Urgent Care centers even if the facility is outside their coverage network, according to a memo DPH released on June 26. Insurers will pay 135 percent of the Medicare reimbursement rate for out-of-network care at all Urgent Cares east of Worcester County, said Michael Caljouw, vice president of government and regulatory affairs for Blue Cross Blue Shield of Massachusetts. Urgent Cares agreed not to bill patients for the remaining balance after insurance reimbursement.

“What the DPH has done is unprecedented,” Jim Brennan, president of the Massachusetts Urgent Care Association, is quoted saying to The Boston Globe: “The department of health is preemptively trying to make sure all patients are aware of resources they have above and beyond the emergency room.”

Urgent Cares are equipped to handle less dire medical emergencies, Brennan said. “For your everyday cough, cold, fever, sutures, we can handle that,” he said. The roughly 200 Urgent Cares in Massachusetts have an average turnaround time of an hour and cost a fifth as much as an Emergency Department. Brennan estimated that about 40 to 50 percent of an Emergency Department’s patient volume could be effectively treated at an Urgent Care.

DPH described the initiative as an effort to address busier summer months. “This agreement will help reduce overcrowding and longer waits for care, as Emergency Department volume is typically high during the summer months,” Olivia James, a spokesperson for the Executive Office of Health and Human Services, wrote in a letter describing the policy change.

Stakeholders said the move is also driven by the ongoing fallout at Steward Health Care, which has been unable to maintain specialized care at its hospitals, stressing nearby hospitals. The nation’s largest for-profit hospital system declared bankruptcy in May, raising concerns about the impact on its seven active hospitals in the state. If any of its Emergency Departments stop operating, the influx of displaced patients could be devastating for the region’s hospitals.

“It’s an already strained Emergency Department ecosystem in Massachusetts,” Caljouw said. “Looking forward, we want to make sure we’re all prepared for continuing care demands during the summertime if and when Steward changes occur.”

Robbie Goldstein, the state’s public health commissioner, acknowledged that Steward was treating fewer patients, causing a trickle-down effect that’s exacerbating overcrowding at Emergency Departments.

“Hospitals, they’re all operating at 100 percent capacity or more,” said Dr. Joseph Kopp, an emergency physician at Brigham and Women’s Hospital and Faulkner Hospital. Overcrowding in Emergency Departments has led to hallways lined with beds, agitated patients, and health care workers pushed to their limits.

Urgent Care centers, therefore, play a crucial role in alleviating this pressure. To ensure continued progress and support for such initiatives, it is vital for individuals to get involved with local UCA chapters and contribute to UCA federal Advocacy efforts. Grassroots Advocacy has been instrumental in driving these changes, and ongoing support will help maintain momentum and improve healthcare access for all.

By engaging with your local UCA Chapter and supporting federal Advocacy, you can help shape the future of healthcare, ensuring that Urgent Care centers remain a viable and accessible option for non-emergency medical needs. This involvement is not only a step towards better healthcare but also a commitment to supporting a system that prioritizes efficient and effective patient care.