Medicare managed care plan to open two walk-in clinics

The facilities in Philadelphia will complement, not compete with, primary care physicians' practices, the insurer says.

By Emily Berry — Posted Dec. 14, 2009

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Two clinics slated to open in early 2010 in Philadelphia are intended to improve Medicare beneficiaries' access to urgent and preventive care. But unlike most walk-in and urgent care clinics, these will be for members only.

The two "Advanced Care Centers" will be available only to members of Baltimore-based Bravo Health. The company covers about 300,000 members under Medicare Part D and Medicare Advantage plans, including 40,000 in the Philadelphia area.

The first center is scheduled to open in January, with a second available by April.

Bravo Health members will be able to walk in or be referred by a primary care physician, said Andrew Aronson, MD, an emergency physician and internist who is vice president for physician practice affairs for Bravo Health.

At least initially, each clinic will be staffed by one physician, nurses and paramedics, he said. Each also will have a full-service laboratory and adjacent pharmacy.

The clinics were developed in response to a gap in care in Philadelphia, Dr. Aronson said. Few primary care physicians have same-day appointments, so for urgent care or a problem that requires a longer visit -- an IV infusion, for example -- the only option is the emergency department. That's inconvenient for the patient and inefficient, he said.

The intention is not to replace care by a primary care doctor, Dr. Aronson said. Clinic staff will send a record of the visit to the patient's primary care physician and encourage follow-up care through that physician rather than at the clinic.

"A business model with one physician for walk-in appointments -- I don't think this is going to affect [physicians'] business," he said.

James Goodyear, MD, president of the Pennsylvania Medical Society and a general surgeon in Lansdale, Pa., said he is less concerned with the prospect of competition from the clinic than with the corporate practice of medicine, when a company directly employs doctors. The medical society opposes the corporate practice of medicine, he said.

"When corporations tend to own physician practices, then health care decisions might potentially be compromised by corporate decision-making," Dr. Goodyear said. "The loyalty of the physician employee may also be somewhat divided between maintaining a profit-making business and the delivery of safe and quality care."

Pennsylvania case law appears to oppose the corporate practice of medicine, and state law bars physicians from working for an "unlicensed individual or corporation," Dr. Goodyear said.

Dr. Aronson said Bravo Health is following all state laws.

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