Status of Urgent Medical Care services in Conifer

URGENT CARE FACIITY STILL OF CONCERN FOR CONIFER RESIDENTS
March, 2023

In every Conifer Community Survey that Conifer Area Council has facilitated, the lack of an Urgent Care Facility has been of major concern to residents. Conifer Area Council heard you and has studied this issue both after the 2010 Conifer Community Survey and again in November, 2021 after concern was raised at the September, 2021 Town Hall Meeting. It again surfaced as a major concern in the 2022 Conifer Community Survey. Following is what we have discovered:

NOVEMBER, 2021

After the September, 2021 town hall meeting, Conifer Area Council made a commitment to research urgent care facilities because it has been identified again as a priority need for our community.
We learned that we are not alone. According to a 2018 survey by Pew Research Center, rural Americans are more likely than people in urban and suburban areas to say access to good doctors and hospitals is a major problem in their community. Nearly a quarter (23%) of Americans in rural areas say this, compared with 18% of urbanites and 9% of suburbanites. Rural Americans live an average of 10.5 miles from the nearest hospital, compared with 5.6 miles for people in suburban areas and 4.4 for those in urban areas, according to the Pew analysis.

Conifer Area Council formed a Study/Action Team to contact local authorities and conduct Internet research on this issue. Here is what we learned about urgent care:

• To be an urgent care facility requires special credentialing.
• The startup costs of a stand-alone ER are around $1.5 million.
• While not a credentialed urgent care facility, Conifer Medical Center provides some emergency care and is open six days a week. The only holidays it closes are Thanksgiving, Christmas and New Years Day.
• For life-threatening emergencies, like a heart attack or head injury, Conifer Medical has to wait for an EMS from the local fire department to transport the patient to a hospital.
• Chief Ware of Elk Creek Fire said that unless there was a legitimate, stand-alone ER that was linked to a hospital, the department would still need to transport patients to a hospital because of strict protocols they must follow. If it is a true emergency, the department would bypass the stand-alone facility for a higher level of care.
• King Soopers in some locations has a Little Clinic, open 24-hours, but the Conifer manager said our location is too small for that kind of service.
• A stand-alone ER needs to be profitable for the operator. It would be difficult to make a profit due to cost of land up here along with the lack of sufficient population, according to sources contacted by CAC. Another issue is staffing, which is already a struggle for the medical community.
• Stand-alone ERs are very expensive for the patient, according to a 9News investigation. They found that providers charge a facility fee in addition to the fee for medical care. According to bills analyzed by 9Wants to Know, UC Health ER, for example, charges a facility fee ranging from roughly $700 to $6,200.
• According to the Journal of Urgent Care Medicine, there is an oversaturation of urgent care facilities in the suburbs across the country. The Urgent Care Association found in 2018 that only 6.7 percent of urgent care facilities are located in rural markets, They speculate that current insurance reimbursement models may not support the costs to operate and staff centers in sparsely populated rural communities, and act as a deterrent for urgent care providers The report states that to break even, most urgent cares need an average of 25 visits a day.
• One promising note from the Urgent Care Association is that some urgent cares in the south are making it work in rural areas. There is also some very preliminary talk of federal subsidies for urgent cares, the report states.

From everything we learned Conifer is not in a position to have an Urgent Care Facility at this time.

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The 2010 Conifer Community Survey identified urgent medical care as a top priority of respondents.  Follow up at Town Hall meetings and a separate email poll of our mailing list confirmed a high level of interest.

CAC created a sub-group to pursue the possibility of working with a local medical practice to create an urgent care center.  Conifer Medical Center had interest in the approach and we met with them several times to determine the possibilities.  After careful consideration, it was determined that setting up an urgent care facility was not a viable option at this time.  There were several reasons for this:

• The requirements to becoming a certified urgent care facility are burdensome.  Medical personnel must be trained and accredited outside of normal primary care standards.  The billing approach for urgent care is different than for primary care services and requires significant changes.
• An urgent care facility requires staffing at night and on weekends.  The population of our area is just not large enough to support this kind of medical presence.
• Over half of the urgent care needs identified by the community (cardivascular issues) couldn’t be treated in an urgent care facility.  Medical protocol requires any cardiovascular events (heart attack or stroke) to be transported to an emergency facility.

We appreciate the interest shown by Conifer Medical Center.  Even though they decided not to pursue designation as an urgent care facility, they have hired additional providers and they offer extended office hours including weekends: Monday through Friday 7 am to 8 pm, Saturday 8 am to 5 pm and Sunday 9 am to 4 pm.

Thanks to all of you who completed our email poll on urgent care.  Because of your interest we spent considerable time and effort doing due diligence on the matter.   Unfortunately, the time for a designated urgent care facility in Conifer is not now.

The following link directs you to the results of the poll.  If you have any questions, comments, or suggestions regarding urgent care in Conifer please email us at [email protected]

http://survey.constantcontact.com/survey/a07e37iib5xghqe1far/results