The problem is that many ER visits are not actual emergencies.  In a 2002 survey, the Centers for Disease Control and Prevention (CDC) noted that almost half of all visits to the ER are neither emergencies nor urgent in nature.  Recent studies suggest that number is rising dramatically.

The California Institute for County Government researched the use of emergency rooms for routine care in August 2004 and concluded, “The misuse of high cost ERs results in an inefficient allocation of resources, thereby raising the overall cost of health care, and is an impediment to the effective delivery of the type of services for which emergency rooms are designed.”

In order words, inappropriate ER use means overcrowding, longer wait times and less focus on patients truly facing life threatening situations.  Additionally, ER visits are about six times more expensive than comparable treatment in a physician’s office.

To combat this issue, Anthem Blue Cross of California is developing an Urgent Care Center Network for members with PPO coverage.  Anthem Blue Cross’ definition of emergency is:  “A sudden, serious and unexpected acute illness, injury or condition (including, without limitation, sudden and unexpected severe pain), which the member reasonably perceives could permanently endanger his or her health if medical treatment is not received immediately.  Urgent Care Centers provide an ER alternative for situations that are not emergencies.

Anthem Blue Cross’ Urgent Care Center PPO Network is a work in progress (facilities will continue to be added).  As of May 2006, Anthem Blue Cross has contracts with 154 sites across 29 counties in California.  All participating network Urgent Care Centers meet Anthem Blue Cross’ health care management criteria.

Effective July 1, 2006, members can find out more information about this network by visiting Anthem Blue Cross’ website at www.anthem.com/ca.  From there, members need to follow the following directions:

1. Select FIND A DOCTOR and complete the steps below (click on CONTINUE after each step.)

2.  Existing members should enter their Anthem Blue Cross member identification (ID) number in the MEMBER PERSONALIZED SEARCH field.  The member ID number can be found on the member ID card (do not include the three digit alpha pre-fix).  If members do not have a member ID number, they should click on the VISITOR SEARCH field.

 3.   Next, follow the appropriate prompts, URGENT CARE CENTER information will be found under the TYPE OF PROVIDER section of FIND A DOCTOR.  There, members should select the “PDF File” link, which will take the member to a downloadable directory of Blue Cross’ current contracted Urgent Care Center sites.

If you should have any questions, please do not hesitate to contact human resources or our benefits broker, PSW Benefit Resources at 877.866.2623.