CHAPTER 17
Physician Extenders in the Urgent Care Center
John Shufeldt and Adam Winger
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THE UTILIZATION OF PHYSICIAN assistants (PAs) and nurse practitioners (NPs) in clinical settings across the United States has grown tremendously since the first decade of the 21st century, and urgent care companies are among the biggest beneficiaries of such growth. This group of professionals treats tens of thousands of patients every day in centers across the country, and it is no surprise that their involvement has become integral to the success of the urgent care industry.
Not only do physician extenders (PEs) increase patients’ overall access to health care but they also do so at a lower cost than care by physicians alone. Unfortunately, in many states, payers use the decreased payroll expenses associated with midlevel providers to justify reduced reimbursement rates for patients treated exclusively by a PA or NP. As a result, many urgent care companies use midlevel providers as much as possible but, to obtain the higher reimbursement levels, require that the physician treat each patient.