Agents’ Opportunity in Growing Urgent Care Market Starts with Knowing Key Risks

By Eric Paynter | June 5, 2019

Over the past decade, urgent care facilities have emerged as popular, convenient and cost-effective alternatives to primary care physicians and hospital emergency rooms. The number of urgent care facilities in the United States has grown exponentially and now represents an $18 billion segment of the healthcare industry, with additional growth expected, according to the Urgent Care Association.

With more patients visiting urgent care facilities than ever before, these facilities continue to expand the services they offer, and consequently, take on more risk. This growing market offers independent agents the opportunity to help clinic owners identify professional liability exposures and mitigate the corresponding risks.

Understanding Key Risks

In spite of their efforts to provide the best possible care, urgent care facilities, as well as the professionals employed, often face potentially damaging malpractice lawsuits. While these facilities face a myriad of professional liability risks, there are three risks that leave the facilities and their professional teams exposed: patient misconceptions of clinic care; expanded provider teams; and an increased reliance on telemedicine. Fortunately, these evolving risks can be reduced through the implementation of specialized insurance programs. With this in mind, agents are advising their clients to partner with experienced carriers that offer broad coverage and comprehensive risk management and prevention solutions to ensure the continued good health of their businesses.

Patient Misconceptions

Given urgent care clinics are often the most accessible form of treatment, patients quickly turn to these centers for care. However, these clinics are primarily devoted to outpatient care for non-emergencies and are not equipped to treat more serious or life-threatening situations. Services can include those similar to a physician’s office or can be broader, including on-site radiology and lab services, and treatments for non-life-threatening issues, such as minor fractures, lacerations, bites and sprains. These clinics are not equipped to treat more serious or life-threatening situations, such as chest pain, coughing blood or excessive bleeding — a common misconception among patients.

Confusion among patients about where to seek care can have catastrophic consequences. When patients visit urgent care clinics for serious, life-threatening situations, often the most appropriate evaluation and treatment is delayed and clinics must request an ambulance to transport the patient to the hospital. Since every minute counts in these situations, delays in care can be potentially devastating and can result in patients or their families making allegations of negligence or professional errors.

Clinics that focus on educating their patients on their treatment capabilities and have strict policies and procedures in place to handle escalations are better positioned to help mitigate this significant issue of where to seek care.

Expanded Provider Teams

While most clinics are physician-led, many rely primarily on nurse practitioners and physician assistants to administer patient care, giving them authority to act independently. Many also employ third-party contractors for their delivery of care. These practices enable clinics to appropriately manage their expenses, but also create additional exposure for the facilities.

While it is important contractors are insured through their own organizations, the use of third-party contractors can also mean clinics need an added level of coverage for these individuals.

Independent agents can recommend coverage that is expansive enough to cover the range of healthcare professionals providing services, including any nurse practitioners, physician assistants, third-party contractors and primary care physicians.

Increased Reliance on Telemedicine

Urgent care clinics are increasingly embracing telemedicine as a cost- and time-effective way to interact with specialists. Using technology, remote health care providers can provide patient evaluations and diagnoses and suggest treatments. Teleradiology is one area that has been at the forefront of the telemedicine movement, enabling remote radiologists to read x-rays or scan results and offer diagnoses. While telemedicine offers many benefits, this form of care can also present an increased risk for misdiagnosis.

For example, teleradiologists rely on the scans or x-rays taken by the on-site technicians when they make a diagnosis. The teleradiologist may see something on the film but misread the severity of the situation due to incomplete or inaccurate images. Issues may also arise as a result of the quality of the teleradiologist or telemedicine professional.

To avoid this risk, clinics must ensure contracted telemedicine professionals are properly trained and up-to-date on the latest technology. Checking backgrounds and credentials thoroughly, and practicing sound contractual risk management, are critical to protecting clinics and their patients.

A Strategic Partner

As urgent care facilities continue to increase in popularity, independent agents can help facility owners understand and identify evolving risks, and partner with experienced carriers to deliver comprehensive and customizable coverage. By playing the role of a strategic partner, agents can guide their clients to solutions that help protect their bottom lines while reinforcing the agencies’ value.

About Eric Paynter

Paynter is vice president of Hanover Healthcare, a division of The Hanover Insurance Group Inc.

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