Unalaska’s main health clinic is updating its billing for same-day visits, which could mean increased rates for some patients.
Because the island doesn’t have a hospital, the Iliuliuk Family and Health Services clinic is the island’s go-to spot for everything from routine primary care to middle-of-the-night health emergencies. Despite that, the clinic doesn’t actually get paid for any emergency care because of its classification as a Federally Qualified Health Center.
That classification allows the clinic to receive federal funds to provide primary care to the community, especially to underserved and low-income patients. It also means the clinic has to charge emergency visits at a lower rate, as primary care, which has contributed to financial deficits in recent years.
Clinic CEO Dawn Johnson said that’s not a sustainable approach for the clinic.
“We can't continue to offer emergency care and not get reimbursed for it,” she said.
But Johnson said they’ve found a way to help alleviate some of those cost imbalances.
“We did a deep dive into the services we provide, realized that urgent care is an allowable service under HRSA [Health Resources and Services Administration] that we can bill for,” she said. “So it's not the emergency care price that we provide, but it's urgent care price. It's better than what we were charging, which is a really low primary care.”
The clinic is certified by and receives some funding through the HRSA.
There’s roughly 4,500 residents in Unalaska, but the population sometimes doubles during the island’s busy fishing seasons. Johnson said the clinic gets a lot of urgent care walk-ins during the peak “A” season, which runs from late December through early spring. She said separating urgent care from primary care appointments also helps with workflow for clinic staff. Even before they began the new billing system on Monday, Johnson said they’ve physically separated urgent care during the busy fishing seasons.
“What we see a lot of during ‘A’ season is flu,” Johnson said. “So like Covid, RSV, that kind of thing. And we want them in a separate lobby than our well-child [visits]. We don't want them all commingling.”
Johnson said the new approach is also more fitting for the care staff is providing.
“In the past, the community [was] accustomed to just showing up when something comes up, and it’s not necessarily urgent care, but maybe, ‘Hey, I just showed up and I want to do my med reconciliation — look at all my meds.’ Well, that's something you can make an appointment for, and should so that we have time set aside for that,” Johnson said.
Previously, all clinic patients were billed at the primary care rate, according to Johnson. Now, depending on the care provided, patients could see increases in their billing if seen for an urgent care visit.
Johnson encourages patients to call ahead to make appointments and to check with their insurance provider to see how urgent care visits might affect their coverage.
Patients can still book same-day appointments, but Johnson said calling ahead could help patients avoid being charged with an urgent care bill.
For more information or to make an appointment, you can call the clinic at 907-581-1202.
