Quick Care expansion opposed

By Emily Richmond

Friday, July 20, 2001 | 11:50 a.m.

Clark County Commissioner Yvonne Atkinson Gates wants a moratorium on University Medical Center's plans to build additional Quick Cares, the public hospital's highly profitable drop-in offices located throughout Southern Nevada.

Some doctors have called the Quick Cares unfair competition because the drop-in medical offices are supported by tax dollars, and administrators aren't concerned with showing a profit.

University Medical Center is the county hospital and as such is subsidized with tax dollars. Part of its mission is to ensure that no one is denied medical care because of a lack of money.

Gates said Thursday she has heard from about six private doctors who are opposed to the Quick Cares. She said she also has concerns about the viability of the Quick Cares if too many are opened too quickly.

"We have saturated the market enough," Gates said. "We don't need to overdo it where we kill the private sector as well."

The proposed moratorium is scheduled to be discussed by the County Commission, which acts as the UMC Board of Trustees, on Aug. 7.

Commissioner Erin Kenny, who chairs the board, said Thursday she is considering supporting a temporary moratorium while UMC's fiscal study of the Quick Cares is completed. The study is expected to be ready by the board's first or second meeting in September.

William Hale, UMC's chief executive, declined comment on the proposed moratorium. He has said in past interviews that the 14 Quick Cares are an integral part of the UMC health network.

UMC officials have said the Quick Cares lost $8 million last year but brought in $17 million in revenue from referral patients. This means the Quick Cares added $9 million to UMC's coffers, officials said.

The private sector can't match the salaries and benefits offered by the county, said Dr. James Hogan.

As employees of the county hospital the Quick Care doctors are protected from lawsuits of more than $50,000, Hogan said. Most private physicians need a minimum of $1 million in malpractice insurance to even open their office doors, Hogan said. Not having to pay the expensive insurance premiums is another attractive Quick Care benefit private doctors simply can't match, he said.

A bill that would have meant stricter regulations for public enterprises that compete in the private sector failed to get out of the state Senate during the recently completed legislative session.

When it comes to commercial ventures, UMC has been more successful than most other public hospitals in the United States, said Larry Gage, president of the National Association of Public Hospitals and Health Systems.

Commercial activities, including the Quick Cares, accounted for 34 percent of UMC's net revenues in 1999, according to a report by Gage's association. In comparison, the average public hospital in the United States received 18 percent of its net revenues as a result of commercial ventures.

UMC's Quick Cares have successfully "diffused" some of the emergency room crush, Gage said Tuesday in a presentation to the board. ER care is often the biggest drain on a public hospital's income, Gage said.

In addition to spreading out the patient base the Quick Cares also direct seriously ill people into UMC's hospital beds, providing another source of income.

UMC is considered a "safety net" hospital because no one is turned away for lack of funds and its mission includes a mandate to care for the indigent. Safety net hospitals nationwide are facing cuts in Medicare and Medicaid reimbursements and a rising number of uninsured patients, which makes the income from commercial ventures such as Quick Cares even more important, Gage said.