Access to Urologic Care at Urgent Care Centers

Area of Science:

• Urology
• Health Services Research
• Health Equity

Background:

• Urgent care centers (UCCs) are increasingly utilized for various medical conditions.
• Access to urologic care can be influenced by insurance status.
• Disparities in healthcare access for Medicaid beneficiaries are a persistent concern.

Purpose of the Study:

• To evaluate insurance access disparities for urologic care at urgent care centers (UCCs) in the United States.
• To compare the acceptance of Medicaid versus commercial insurance at UCCs for a simulated urologic condition.
• To identify factors associated with Medicaid acceptance at UCCs.

Main Methods:

• A cross-sectional study employed a "secret shopper" methodology.
• 240 UCCs across 8 states were sampled, simulating a patient with obstructing nephrolithiasis.
• Researchers used standardized scripts to inquire about insurance acceptance (Medicaid vs. commercial) and referral pathways.

Main Results:

• Commercial insurance was accepted by 99.6% of UCCs, while Medicaid was accepted by 66.2%.
• UCCs in Medicaid expansion states showed higher Medicaid acceptance rates (74.2% vs. 58.3%).
• Medicaid-insured patients were less likely to be triaged or referred to the emergency department.

Conclusions:

• Significant disparities exist in UCC access for Medicaid patients with urologic conditions.
• Insurance type is a key factor influencing access to urgent urologic care.
• Findings highlight potential sources of insurance-related disparities in urologic emergencies.