Hartford HealthCare is expanding across Connecticut. Its urgent care centers have lower costs than hospital emergency rooms. – Hartford Courant

As Hartford HealthCare extends its reach across Connecticut, the number of its urgent care centers that offer patients an alternative to costly emergency rooms is growing, too.

The 28 centers are far afield from Hartford, stretching north to Enfield, south to Branford and West Haven, and east to New London and Norwich. In January, Hartford HealthCare opened an urgent care center in Milford, its first on Connecticut’s shoreline.

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“It’s a more purposeful move to disrupt ourselves,” said James P. Cardon, Hartford HealthCare’s executive vice president and chief clinical integration officer.

Urgent care centers treat illnesses and injuries that aren’t life-threatening, provide X-rays and offer COVID-19 evaluation and testing. Patients may walk in or reserve a place and pre-register online. Hartford HealthCare describes its GoHealth Urgent Care centers as an “on-demand consumer-centric care platform that serves as the digital and physical front door” to its health care system.

“We recognized years ago that we needed to provide new ways to both improve access for urgent care outside of the primary care office while at the same time give better options for those who would have gone to the more expensive emergency department for that care,” said Jeffrey A. Flaks, president and chief executive officer of Hartford HealthCare.

Spencer Perlman, managing partner and director of health care research at Veda Partners in Bethesda, Md., said the industry has focused on urgent care for a while.

“No doubt receiving care in the emergency room is the most expensive place you can receive it,” he said.

By keeping overhead lower than at an emergency room, urgent care centers can be profitable for the provider, Perlman said. Urgent care centers boost profitability because they don’t require the same level of staffing and types of equipment that must be on hand in emergency rooms, he said.

Hartford HealthCare in 2020 posted $274.7 million in operating revenue for its Hartford HealthCare Medical Group, which includes urgent care centers, primary care, surgical care and specialty medicine. It was down from $330 million in 2019 before COVID-19. Its 2020 revenue accounted for about 6.5% of Hartford HealthCare’s $4.3 billion in revenue.

A 2021 study by the federal Centers for Medicare and Medicaid Services analyzing data from six states estimated that the cost savings from switching emergency department care to urgent care centers could save about $3.3 billion annually, according to Hartford HealthCare.

The study cited $570 in copays and $250 out-of-pocket for emergency department treatment of the same conditions that would cost $156 in copays and an average $50 out of pocket at urgent care centers.

Hartford HealthCare says visits to emergency departments declined 10%, or 38,000 fewer patients, between 2016 and 2019, before the pandemic, as patients had access to expanded urgent care.

The cost difference between an emergency room visit for routine care that did not require hospitalization and an urgent care visit is more than 80%, Hartford HealthCare said.

For example, most Hartford HealthCare urgent care centers use mobile X-rays that are more convenient and less expensive than imaging equipment in hospitals.

Employers are encouraging their workers to use alternatives to emergency rooms. A Kaiser Family Foundation survey in 2020 reported that 79% of firms with 10 or more employees offering health benefits cover health care services at retail clinics, such as those in pharmacies, supermarkets and retail stores, in their largest health plan.

Among firms with 10 or more employees covering health services in retail clinics in their largest plan, 17% provide a financial incentive for workers to use a retail health clinic instead of visiting a traditional doctor’s office.

Cardon said that for life-threatening emergencies such as heart attacks, a high level of training from physicians and proximity to a hospital are “all those things that make emergency rooms important.” Strep throat, a sinus infection or twisted ankle is not an emergency and using hospital emergency rooms is a waste of time and money, he said.

Hartford HealthCare has an aggressive growth strategy, adding the Hospital of Central Connecticut in New Britain in 2011, Backus Hospital in Norwich in 2013, Charlotte Hungerford Hospital in Torrington in 2018 and St. Vincent’s Medical Center in Bridgeport in 2019.

It added the Southington Surgery Center in 2014, opened the Bone and Joint Institute in Hartford in 2016 and the Connecticut Orthopedic Institute in Meriden in 2017.

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A new urgent care center followed at least one of those initiatives: St. Vincent’s Medical Center had five urgent care centers and Hartford HealthCare added a sixth last year.

Hartford HealthCare’s expansive strategy won’t necessarily lead to more urgent care centers, Cardon said.

“The goal has always been to move away, try to provide services in the community where they live,” he said. “It depends where the need is. There are no pre-set numbers. We look at the communities.”

Hartford HealthCare’s growth has drawn a federal lawsuit by St. Francis Hospital and Medical Center in Hartford, accusing it of jeopardizing competition and limiting consumer choice. It’s seeking unspecified damages and an order prohibiting Hartford HealthCare from continuing its acquisitions.

Asked if Hartford HealthCare’s urgent care centers help steer patients to its hospitals or other facilities, a spokeswoman said patients and their providers determine care and where to seek health care.

“It’s a piece of this puzzle to address the total cost of care,” Cardon said.

Stephen Singer can be reached at [email protected].