- Bill Wang is a research assistant in the Department of Health Care Policy, Harvard Medical School, in Boston, Massachusetts.
- Ateev Mehrotra is an associate professor of health care policy and medicine in the Department of Health Care Policy, Harvard Medical School.
- Ari B. Friedman ([email protected]) is an assistant professor of emergency medicine, medical ethics, and health policy in the Departments of Emergency Medicine and Medical Ethics and Health Policy and senior fellow of the Leonard Davis Institute, University of Pennsylvania, in Philadelphia, Pennsylvania.
There is substantial interest in using urgent care centers to decrease lower-acuity emergency department (ED) visits. Using 2008–19 insurance claims and enrollment data from a national managed care plan, we examined the association within ZIP codes between changes in rates of urgent care center visits and rates of lower-acuity ED visits. We found that although the entry of urgent care deterred lower-acuity ED visits, the impact was small. We estimate that thirty-seven additional urgent care center visits were associated with a reduction of a single lower-acuity ED visit. In addition, each $1,646 lower-acuity ED visit prevented was offset by a $6,327 increase in urgent care center costs. Therefore, despite a tenfold higher price per visit for EDs compared with urgent care centers, use of the centers increased net overall spending on lower-acuity care at EDs and urgent care centers.