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Top 14 Urgent Care Center Chains in the U.S.

There are about 6900 urgent care centers in the U.S. according to the Urgent Care Association of America. While the market is fragmented, Health Data Management has identified the largest urgent care operators in U.S with the most centers. There were 1,074 hospitals that reported operating urgent care centers in 2013 based on the American Hospital Association’s Annual Survey.

Topping the list is Concentra with over 300 clinics located in 38 states. Concentra is jointly owned by Select Medical and a private equity firm. In the second and third positions on the list are U.S. Health Works, a Dignity Health subsidiary, with 190 sites in 20 states, and American Family Care and Doctors Express with 168 centers in 26 states.


Top 14 urgent care center chains in the U.S. HealthData Management slideshow, Nov. 18, 2015. http://www.healthdatamanagement.com/gallery/fourteen-top-urgent-care-center-chains-in-the-US-51565-1.html

AHA Hospital Statistics, 2015 edition. Health Forum, an American Hospital Association affiliate, 2015. http://www.ahadataviewer.com/book-cd-products/AHA-Statistics/

Posted by AHA Resource Center (312) 422-2050, rc@aha.org


EDs: Freestanding hybrid emergency departments / urgent care centers

Centura Health (Englewood, CO) has formed a joint venture partnership with The Larkin Group to open four freestanding emergency departments / urgent care centers.  These new outpatient facilities will be open 24/7.  It is expected that the patients will be primarily urgent care patients.  These hybrid centers are said to be the first of their kind in the Rocky Mountain west, but there has been a proliferation of freestanding EDs in Colorado, which 20 opening since 2014.


Rubenfire, A. (2015, Nov. 11). Centura Health to open hybrid ED/urgent-care centers. Modern Healthcare. Retrieved from http://www.modernhealthcare.com/article/20151111/NEWS/151119995 

Olinger, D. (2015, Nov.10). Centura to open hybrid centers in Colorado for ER, urgent care. The Denver Post. Retrieved from http://www.denverpost.com/news/ci_29098146/centura-offer-cheaper-urgent-care-option-at-new 

Centura Health and The Larkin Group form new joint venture. (2015, June 22). News Release. Retrieved from https://www.summitmedicalcenter.org/centura-health-press-releases/centura-health-and-the-larkin-group-form-new-joint-venture/#.VkyuktKrRhE  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

OPERATING ROOMS: Relative humidity below 30 percent raises concerns

In 2010, the American Society of Heating, Refrigeration and Air Conditioning Engineers (ASHRAE) changed its standard for relative humidity in the operating room.  The previous recommendation was for a range of 30 to 60 percent; the revision drops the lower range to 20 percent.  This position paper issued jointly by the American Hospital Association, the Health Industry Distributors Association, and the Association of Operating Room Nurses, among others, raises concerns about this change because of the sensitivity of certain electro-medical equipment to dry air conditions.  A series of questions that a hospital or ambulatory surgery center might use to analyze the issues related to dropping to 20 percent humidity are included.

Source: Relative humidity levels in the operating room: Joint communication to healthcare delivery organizations. (2015, Jan.). Retrieved from http://aorn.org/-/media/aorn/guidelines/position-statements/posstat-endorsed-relative-humidity-joint-communicaiton.pdf

Health Policy Brief: Enforcing Mental Health Parity

There have been legislative and regulatory efforts over the years to bring mental health treatment and coverage to an equal level as that for other health issues.

Most recently, Congress passed the Mental Health Parity and Addiction Equity Act (MHPAEA) in 2008, and the Affordable Care Act specified mental health and substance abuse treatment as an essential health benefit for Marketplace health plans. Earlier this year, the Centers for Medicare and Medicaid Services released proposed regulations for implementing the MHPAEQ.

This updated policy briefing looks at the issue of mental health parity, its background, current law, the debate, and what’s next. It addresses access; equivalence, quality and efficacy of services; Medicaid; and has a new focus on enforcement.

Source: Goodell S. Health Policy Brief: Enforcing mental health parity. HealthAffairs.org, Nov. 9. 2015. http://healthaffairs.org/healthpolicybriefs/brief_pdfs/healthpolicybrief_147.pdf

Related: National Alliance on Mental Illness, A long road ahead: achieving true parity in mental health and substance use care.  April 2015.  http://www.nami.org/About-NAMI/Publications-Reports/Public-Policy-Reports/A-Long-Road-Ahead/2015-ALongRoadAhead.pdf

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

BIRTHS: About one-third of all births are C-sections


In the United States, about one-third of all live births today are via cesarean section, according to national data from the U.S. National Center for Health Statistics.  The most current statistic is:  32.2 percent in 2014, compared to what is described as the peak of 32.9 percent in 2009.  When the data are analyzed according to race/ethnicity, the group with the highest percentage of c-sections is non-Hispanic black women (35.6 percent in 2014).

Source: Martin, J.A., Hamilton, B.E., and Oserman, J.K. (2015, Sept.). Births in the United States, 2014. NCHS Data Brief, 216.  http://www.cdc.gov/nchs/data/databriefs/db216.pdf Posted by AHA Resource Center (312) 422-2050, rc@aha.org


A separate report from the National Center for Health Statistics shows that in the ’90s, the c-section rate was much lower – holding at about 20 to 23 percent overall.

Source: Martin, J.A., and others. (2015, Jan. 15). Births: Final data for 2013. National Vital Statistics Reports, 64(1), 49.  http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_01.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

ADVANCE DIRECTIVES: Making choices for the end of life

Over one-quarter of Medicare payments are made for patients in the last year of their lives.  There can be a disconnect between what patients want in terms of medical care and treatment at the end of their lives and what actually happens once 911 is called.  There have been attempts to address this disconnect through development of advance directive documents (which can go missing over time or be misinterpreted).

Here are some resources to help in end of life planning.

Gundersen Health System has implemented an advance directive program  that has resulted in an almost perfect match between a dying patient’s wishes and treatment decisions.  Also, the cost of care during the last two years of life, as well as the intensity of hospital care during this period, is lower than the national average.

Source: Fifer, J.J. (2015, Nov.). Time to break the last taboo. HFM. Healthcare Financial Management, 69(11), 28. Retrieved from http://www.hfma.org/Content.aspx?id=42943

CARE COORDINATION: Hospital leases beds at skilled nursing facilities and cuts 30-day readmission rate

UCLA Health (Los Angeles), which operates Ronald Reagan UCLA Health, and Santa Monica UCLA Health, is collaborating with local skilled nursing facilities (SNFs) through a bed leasing program.  The academic medical center pays a negotiated daily fee to hold SNF beds open so that patients ready for discharge but who have been hard to place have a postacute facility to go to.  Despite the bed lease cost, the advantages of being able to move patients out of the acute care setting and decrease the 30-day readmission rate have resulted in the program being a financial success.

Source: Bed leasing program helps hospitals discharge hard-to-place patients. (2015, Dec.). Hospital Case Management, 23(12), 158, 163.  Retrieved from http://www.ahcmedia.com/articles/136601-bed-leasing-program-helps-hospitals-discharge-hard-to-place-patients Posted by AHA Resource Center (312) 422-2050, rc@aha.org


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