Urgent care center accreditation now required by multiple payers

Urgent care owners, operators, physicians and staff, take note: payers across the country are increasingly requiring certification or accreditation before contracting or as a requirement to remain in-network.

Payers requiring this expectation in just the last month include Blue Cross Blue Shield of Georgia and Empire Blue Cross Blue Shield in New York, for all new urgent care centers.

These moves showcase the numerous advantages available for centers that fulfill high standards of urgent care accreditation, and underscores how payers and consumers are increasingly demanding proof of value and quality from healthcare services – including the 7,357 urgent care centers around the country that each see an average of 12,000 patients per facility each year.

Accreditation distinguishes urgent care centers, as accredited centers must implement key procedures and demonstrate that they have met nationally standardized criteria to provide high-level care and achieved excellence. Accreditation is only awarded to organizations that meet national standards and best practices for safety, quality and scope of services.

Urgent care is a vital part of the continuum of care, working in cooperation with emergency rooms, primary care physicians and other on-demand healthcare services, so meeting and demonstrating high standards is of paramount importance, especially as our industry continues to experience rapid growth.
Accreditation provides a competitive advantage with payers and helps set an urgent care center apart from other centers. Now that more and more payers are requiring certification or accreditation in order to remain in-network or for contracting, there is even more incentive for urgent care centers to seek and achieve accreditation. Urgent care accreditation recognizes not only the scope of services offered at an urgent care, but the more traditional processes associated with quality and safety. Accreditation processes and requirements have been developed by urgent care professionals for urgent care professionals, and they address the unique challenges and day-to-day operations exclusive to the industry.

Urgent care accreditation can help urgent care centers stay in-network for select payers. The accreditation process also helps centers develop and implement consistent processes across all sites, assuring every required standard is a routine practice. This has resulted in operators realizing often unanticipated efficiencies.

Some external organizations, from payers to state agencies, may no longer deem it necessary to conduct their own tours or inspections of urgent care facilities once a center goes through the accreditation process. Additionally, medical malpractice insurance carriers are taking notice of urgent care accreditation for its impact on quality and safety, with some offering organizations a risk management credit on their premium of 2.5 to 15 percent.

Many centers find that simply going through the accreditation process, which enlists staff to focus on the values of quality, safety and scope, ultimately results in more engaged, patient-focused employees. Achieving accreditation requires teamwork that generates a sense of pride and accomplishment. Accredited centers undergo rigorous site surveys and are awarded accreditation based on surveyor findings and the recommendations of the accreditation committee. This accreditation process gives patients the peace of mind that an accredited center provides the highest quality of care – a trustworthy 'seal of approval.'

With a focus on issues like patient flow, patient comfort and how centers treat patients, accreditation confirms that patient-centered care is what is important, and is at the core of the urgent care practice. Urgent care accreditation also helps centers respond to changing consumer behavior. Patients are increasingly likely to select cost-effective, high-quality providers, such as urgent care's quality healthcare professionals: board-certified physicians, board-certified physician assistants and board-certified nurse practitioners.

Centers marketing their urgent care accreditation can achieve greater success with referral sources, such as pharmacists, school nurses and risk managers. Urgent care accreditation is designed for implementation at most types of urgent care facilities, and can be implemented by building on the processes and systems urgent care centers likely already have in place.
As healthcare professionals, we strive to provide an exceptional patient experience. Earning urgent care accreditation affirms our commitment to quality, safety and excellent clinical outcomes by ensuring that our urgent care organizations across the country are providing the highest safety measures and quality of care to our patients.

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