Urgent care, primary care, walk-in or retail clinic? Discuss.

Filed Under: Costs, Patients, Providers

SUMMARY: Urgent-care or walk-in? Primary care or retail medicine? What’s the difference? What happened to my old doctor’s office visit? and what’s the difference between membership medical and walk-in clinics? We help you sort it all out. Read on for details, or …

 

 


How much does a walk-in clinic visit cost?

Well, that depends.

While researching the price of a basic initial visit at “urgent-care” clinics in the tri-state area, we at CHC realized that not all of these clinics considered themselves “urgent-care” at all.

Some call themselves “walk-in” clinics while others are “primary-care” clinics that take walk-in patients who need urgent care. Confused? We were, too.

The differences between urgent-care and walk-in centers are often ambiguous. Some clinics that label themselves as “walk-in” will see a patient who urgently needs medical care, while other “walk-in” clinics will not. To confuse things further, many primary care facilities take “walk-ins,” while some “walk-in” centers require that you call ahead.

What is the difference, anyway?

To give you examples of the ambiguity, here are a few explanations that CHC received in phone reporting:

Representatives of Continuum Beth Israel walk-in clinics told us that they are a “walk-in primary care facility.” You can choose to drop by to see a doctor for minor or urgent matters. Or you can make an appointment ahead of time.

Representatives at City MD told us that they are an “urgent care walk-in center” that does not take appointments. Like Beth Israel, they will see people with urgent matters or a bad cold.

The bottom line? Both Beth Israel and City MD are “walk-ins,” both will see you if you have an urgent matter or a bad cold, however each has a different policy on appointments.

Urgent-care only, or after-hours care

Then there are the strictly “urgent-care” centers. We called Summit Medical Group Urgent Care in Berkeley Heights, N.J., and the told us that they are “urgent care only,” which means they will not accept anyone who walks in with a sore throat, cough or headache. They treat urgent matters such as broken bones and gaping wounds. The only difference between Summit Medical Group Urgent Care and the ER is that they claim to have shorter waiting times and are not 24 hours.

And there’s “after hours care.” Preferred Health Partners, with centers throughout Brooklyn, is a primary care facility that offers “after hours care” (Fridays from 6 p.m. to 10 p.m. and Saturdays and Sundays from 10 a.m. to 7 p.m.).

What does “after hours care” mean? It means you can walk in without an appointment, whether the matter is urgent or the common cold, but only during these hours.

Membership medical and retail clinics

Finally there are primary-care membership medical groups such as One Medical Group, with offices in New York, San Francisco, Washington, Boston and Chicago, that offer same-day appointments. The concept behind membership medicine is that the patient pays an annual fee (the retainer) in exchange for enhanced care. Membership medical groups differ in the level of service provided and the amount of the fee charged. One Medical Group New York,told us that it is not a walk-in clinic or an urgent care center. Members can make same-day appointments for non-urgent matters.

And, there is the “retail clinic,” which is often in a pharmacy, or a grocery store, or a big-box store like Walmart. (This term, too, is a bit confusing — you might think retail clinics are the storefront clinics on New York streets, but that’s not really what this term means.) These  retail clinics are often staffed by a pharmacist or a nurse practitioner; they might help people with flu shots and minor complaints like strep throat or ear infections. These clinics are on the rise.

(For distinctions between retail clinics and membership medical, with a skip over walk-in and urgent care, read a previous post.) Retail pharmacy chains often offer shots; you can read that post here.

“There are now more than 1,300 retail health clinics nationwide, according to the non-profit RAND Corporation,” Amy Norton wrote in Reuters Health in November 2012. “And among Americans with private health insurance, their use rose 10-fold between 2007 and 2009.”

Extra stuff: This might be oversimplifying, but we’re trying to deliver answers.

One could argue that, aside from being “urgent,” urgent care means that you don’t need a membership and you don’t need an appointment. You can simply drop in and be seen – often with a shorter wait than the ER.

On the flip side, primary care implies making an appointment for something not urgent but possibly same day. Usually primary care offers preventive and routine care.

And a walk-in is any place that you can walk into without a previous appointment. Whether or not you are guaranteed to see a doctor that day, however, is not always guaranteed. Again, it depends on where you go.

Retail clinic? It sort of acts like, well, retail. And a membership group requires a membership.

So, how much will it cost?

We have collected cash or self-pay prices over a number of metro areas for walk-in, urgent care, direct-pay and membership medical practices. Those charges may vary, depending on whether your insurance covers all or part.

But the cash or self-pay prices vary a lot. Our New York area provider price survey shows a range from about $75 a visit up to $351.

Our Los Angeles area provider price survey shows a range from about $20 a visit up to $300.
Our San Francisco area provider price survey shows a range from about $99 a visit up to $310.
Our Dallas-Fort Worth area provider price survey shows a range from about $75 a visit up to $375.
Our Houston area provider price survey shows a range from about $75 a visit up to $250.

The takeaway: Questions to ask

As we always say, know before you go.

Questions to ask:

  • Do you accept my insurance plan?
  • How much will this cost? How much will this cost ME?
  • What medical services do you provide?
  • What practitioner is on duty now—a doctor, a nurse practitioner?
  • What practitioner will I see when I come?
  • What is your staffing level in off hours?
  • Are lab and other tests included? If not, how will they be done, how much will they cost, and how will they be paid?
  • Is this covered by insurance without a copay? If not, why not?
  • Do you have a sliding scale based on income, family size and other factors? How does that work?
  • Is there a separate charge for any and all other services, or is it all included in the price you just named?

Call before you go. Ask how much you will be charged. Take notes. Take names. Take numbers.