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State Medicaid Expansion Opportunities for UC

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State Medicaid Expansion and the Opportunities for Urgent Care

1 hour Audio and Power Point Presentation

Recorded September 24, 2015

As states either accept the present Obamacare system or develop plans of their own, more uninsured will now have health care coverage. But if urgent care centers can’t make money at Medicaid rates or if State Medicaid Programs don’t recognize the urgent care delivery model, these newly insured by Medicaid will not have any option other than the emergency room. Successful urgent care programs will have to demonstrate true cost savings versus the emergency room as well as have to deal with longitudinal care (referrals to primary care and specialists) for Medicaid populations, and extended hours coverage.

Learning Objectives:
  • 1. Discuss the present federal Medicaid system, its pros and cons and opportunities for urgent care centers
  • 2. Analyze innovative models that other states are developing as options to standard Medicaid
  • 3. Discuss the roles of incentives and their strategic importance in a successful Medicaid model
  • 4. Discuss strategies to improve and enhance Medicaid networks so that increased insurance does not lead to decreased access
  • 5. Discuss new potential opportunities for urgent care centers in the Medicaid environment.

Faculty Bio:

Steven M. Berkowitz, MD  - Board certified in internal medicine, Dr. Berkowitz is the Founder and President of SMB Health Consulting, specializing in assisting physicians and hospitals with clinical/ operational performance improvement, strategic planning and leadership development. He has worked with over 150 clients in all 50 states. Previously, for 13 years he was Chief Medical Officer for St. David’s Healthcare, a six-hospital system in Austin, Texas, as well as Division Chief Medical Officer for HCA, which also included facilities in El Paso. As a member of the senior executive team, he had the overall responsibility of clinical outcomes improvement, physician development, strategic planning, and medical management for the Division. During this time he directed the implementation of numerous initiatives and programs to improve the system’s clinical effectiveness. St. David’s mortality index and CMS core measures are now among the best in the nation. In 2008 St. David’s received the Texas Award for Performance Excellence. St. David's was the 2014 recipient of the Malcom Baldrige Award. He was also Chairman of Capital Area Providers, a 5.01-(a) Texas medical foundation with over 850 physicians. Prior to this position, Dr. Berkowitz was the National Practice Leader for Physician Services with the HayGroup, assisting over 75 major healthcare clients throughout the USA and Canada in the areas of strategic development, physician integration, physician compensation, and medical practice management. He was recently appointed Chairman of the Board of the Texas Institute of Health Care Quality and Efficiency by Governor Perry. He also sits on the Board of the Society of Cardiovascular Patient Care. He has been on the Board of the Texas Hospital Association, the Texas Health Care Information Council, and the Texas Association of Health Care Quality.  

Disclosure:  The above faculty had no relevant financial relationships to disclose.

Credit Information:

Designation Statement
The Urgent Care Association of America designates this enduring material activity for a maximum of 1 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

Accreditation Statement
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education. Credit for this course is good for 1 year after purchase.

Urgent Care Management Certificate (UCMC) Credit 
This course is designated for 1 credit of Legal & Regulatory towards the Urgent Care Management Certificate.

Submitting for Credit:  

If you would like to submit for either of the credit above, once you complete the activity you must submit for credit you will need to complete the 5 question exam.  You must answer 3 out of 5 correctly to receive credit.  Your credit will be placed in your profile under Professional Development or click on "My Credits".  Email with questions.  

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