One word defines health care right now: consolidation.
Pharmacy benefits managers (PBMs) are merging with insurers. United Health Group led the charge a few years ago, buying Catamaran. Now CVS is buying Aetna and Cigna is buying Express Scripts. Walmart is in talks to buy Humana. Some see this as motivated by the potential for Amazon to leap into the health care space; the major players are joining forces to ensure they’ll be able to compete.
But the joining of PBMs with insurers could have an effect on hospitals as well.
UnitedHealth bought Surgical Care Affiliates to expand into primary and urgent care in ambulances, and picked up a physician group, moving closer to direct delivery of medical care. CVS and Aetna plan to add community medical clinics to their repertoire. Walmart already operates retail health clinics and has said it would begin offering lab-testing services in some stores.
The $18 billion urgent care center space is expected to grow nearly 6 percent in 2018, building on the more than 7,600 urgent care centers in the U.S. as of June 2017. The number of centers in 2017 was up nearly 10 percent over 2015.
The surge in clinics could be the reason that customer satisfaction with emergency room services jumped 6 percent since last year, to an ACSI score of 73.
That was the most dramatic change in the health care and social assistance sector, and drove the 1.3 percent increase in customer satisfaction with hospitals.
Inpatient hospital care saw a 1 percent rise to an ACSI score of 77. The gains in ER and inpatient care helped offset a decline for outpatient care, which ebbed 3 percent to 78.
Patient satisfaction with ambulatory care (office visits to doctors, dentists, optometrists, and mental health professionals) held steady at 77 for the third year in a row.
Among patients 51 years and up, satisfaction with hospitals was much higher, at a score of 80, than among those 18-50 years old, where it stood at just 72. The difference in satisfaction between the two age groups was most pronounced in outpatient care and emergency room services, where ACSI scores among those 51 and up were 10 points higher than scores for those 18-50.
It will be interesting to see the effect that continued growth of urgent care clinics will have on ER perception moving forward. And when Amazon, along with its collaborators JPMorgan Chase and Berkshire Hathaway, does make moves in health care, it will be anyone’s guess how the health care and social assistance sector, and patients’ satisfaction with its services, will respond.