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Independence Blue Cross expands Urgent Care Center benefit

New web tool and coverage solution offers more access, greater options, increased convenience

Philadelphia, PA – Independence Blue Cross (IBC) is expanding members’ access to care by adding coverage for treatment at urgent care centers and introducing a new web tool to help members locate these centers—

Expanding access to urgent care is the newest option for care that IBC is offering members.  Urgent care centers can provide a convenient, more efficient, and often less expensive alternative to overcrowded emergency rooms for a person dealing with a non-life-threatening condition. The expanded benefit took effect in April.

The new web tool will make it easier for members to find urgent care centers and retail clinics for care for nonemergency conditions when their personal physicians are  not available, like evenings and weekends.Members can also use this tool to help decide when it’s appropriate to use an urgent care center and when an emergency room is necessary.

“We know our members lead busy, demanding lives and sometimes need access to good medical care  when their family doctors aren’t available, but don’t want to go to busy, more costly emergency rooms,” says Daniel J. Hilferty, IBC president and CEO. “That’s why we’ve added coverage for urgent care centers and retail health clinics which provide safe, cost-effective care quickly and  conveniently. This is just one more way we’re changing the game so members can get care when they need it the most along with the tools and information to make wise health care decisions.”

“Whether members choose to visit one of our network doctors, a retail health clinic, or an urgent care center — each can serve as a convenient alternative for conditions that require prompt medical attention, but do not pose an immediate, serious health threat,” said Richard Snyder, M.D., IBC’s chief medical officer. “Options like these may also control unnecessary visits to the ER and help reduce overcrowding by enabling doctors to focus on patients with truly, life-threatening emergencies.”

In fact, a 2010 RAND Corp. study has shown that roughly 17 percent of all visits to hospital emergency departments nationally could potentially be treated at retail based health clinics or urgent care centers for an estimated savings to consumers of $4.4 billion. The study reports that ER visits also are getting longer, with Pennsylvania ranked 22nd nationally in the length of its ER waits — of nearly four hours — according to the Emergency Department Pulse Report, Press Ganey Associates, 2010.

Consumer Tips: Choosing Care Options to Meet Your Medical Needs
“When you’re home with a fever, a sore throat, or an ear ache at 8 p.m. on Friday, what do you do?” asks Dr. Snyder. “Understanding what kind of care you need is important. While your instinct may be to rush to the emergency room, non-life-threatening needs are best cared for at your primary care doctor’s office. If you’ve tried to see your doctor, but still need care after hours, a retail based health clinic or an urgent care center may be right for you.”

Dr. Snyder adds, “However, if you have a life-threatening medical situation, such as uncontrolled bleeding or chest pain with shortness of breath, you should always call 9-1-1 or seek treatment at the nearest hospital emergency room. Alternatives like urgent care centers and retail based health clinics are designed to complement your doctor’s office by providing a place to treat minor injuries and illnesses often seen at a doctor’s office but that cannot wait until the office is open. Fortunately, IBC offers its members among the largest number of patient-centered medical homes in the country. These medical homes use high-tech patient scheduling systems to help ensure that patients are seen when they need to be seen, since these offices keep a schedule of open appointments during office hours to tend to members’ urgent medical needs.”

Still, if your doctor is unavailable, it is important for people to know that they have options for less serious ailments, such as retail based health clinics and urgent care centers that provide care for non-life-threatening needs and can cost  significantly less than an emergency room.”

For instance, emergency rooms that contract with IBC generally charge $550 to $750 to treat strep throat compared with an average of $110-130 at urgent care centers and at retail health clinics. Members can save out-of-pocket expenses because ER copays average around $100, compared with $20 to $70 copays for retail based health clinics and urgent care centers.

Enhanced Access Options

  • Patient-centered medical homes. Patient–centered medical home is a new model of primary care delivery recognized by the National Committee of Quality Assurance to improve access to and the coordination of care for members. These practices are organized with a physician who leads a team of care managers and health educators who help chronically ill patients receive key tests, take medication as directed, and maintain their optimal health status. Patients who are cared for in a medical home typically have more timely access to their physicians.
  • Retail based health clinics. Retail based health clinics are walk-in clinics that are staffed by certified registered nurse practitioners who can treat minor, uncomplicated illnesses and injuries. These retail based health clinics are located in CVS, Walgreens, Shoprite, and other locations, and have available evening and weekend hours. Some retail based health clinics may also offer flu shots and vaccinations.
  • Urgent care centers. Urgent care centers are walk-in facilities staffed by board-certified doctors who can treat illnesses or injuries requiring immediate medical attention. Examples include sore throat, fever, sinus infection, ear ache, cuts, sprains, and broken bones. These centers are typically open 24/7. Urgent care centers currently participating in IBC’s network can be found using IBC continues to actively recruit more urgent care centers in convenient locations where our members live and work.


Media contact:
Karen Godlewski