Urgent Care Centers ‘Billing on Hope’ for COVID-19 Tests

August 25, 2020

Senior Editor Peter Wehrwein speaks with Lou Ellen Horwitz, CEO of the Urgent Care Association, in this part two of two video series about centers that have not been paid yet for tests.

Urgent care centers are testing patients for COVID-19. But the reimbursement to the centers for that testing “is still kind of murky,” according to Lou Ellen Horwitz, CEO of the Urgent Care Association.

“I don’t know anyone who has actually gotten paid yet, so we are billing on hope that this going to be worked out because everybody says it is going to be worked — ‘we are committed to being part of the solution,’— etcetera, etcetera,”Horwitz said in a recent video interview with Managed Healthcare Executive

In follow-up email, Horwitz explained that urgent care centers are usually paid a capitated rate that covers the normal run of problems seen in urgent care, including tests for flu. But her members want payers to go beyond the usual capitated rate and reimburse for COVID-19 tests. Horwitz said that her members operate on a thin margin and without the additional reimbursement, every patient tested for COVID-19 may be a patient that costs the urgent care center money.

Horwitz said that it is unclear what role urgent care centers might play in administering a COVID-19 vaccine, if and when one becomes available. She noted that urgent centers are part of flu immunization protocols “and have been forever.”

“At least give us an opportunity to be part of that,” she said.

Horwitz, whose association represents about 4,500 urgent care centers, noted that urgent care centers don’t have the clout that hospitals and some other providers others. As a result, they have had to jockey for position in the COVID-19 response. Personal protective equipment and access to testing, especially the equipment for rapid tests, have sometimes been in short supply. Horwitz said urgent care centers are testing patients for COVID-19 but are, for the most, sending the samples out to labs rather than using the rapid-test machines.


Horwitz said patient volumes at urgent care centers were at record levels in July because of the combination of normal kind of problems seen at urgent care centers and the addition of COVID-19-related issues.

“I am not getting the sense of, ‘Oh my gosh, we are going to have close our doors.” That is how everybody felt the first week in April — ‘is anyone ever going to come back again?’”

The challenges now are more operational than financial, says Horwitz, as the urgent care centers owners and manager have to decide whether to add staff for the upcoming flu season and what might be a second wave of COVID-19.

Horwitz said there is a lot of discussion of a “four in one” test that would assess, more or less simultaneously, whether a patient has flu, strep throat, COVID-19 or respiratory syncytial virus (RSV). She noted that there will be a danger this fall and winter of assuming it is COVID-19 when other infections might be making people ill.