Enter the placid halls of the Zoom+Super clinic, a stand-alone ER, and you’re met with a trendy design, pastel blues and high-quality photo wallpaper of Oregon’s coastal forests inside seven tidy observation rooms -- a far cry from the harried experience and long delays that a patient might receive at a traditional hospital emergency room.
“It’s a very quiet environment, very different from a hospital here,” said Dr. Mark Zeitzer, the practice leader for emergency medicine, who formerly worked as an emergency physician at Silverton Hospital east of Salem.
Patients either show up or register for an appointment online or on their phone through the Zoom app. They’re in and out in a little more than an hour, and for those paying cash, the price is fixed at $299 a visit, far below the $2200 one can expect from a hospital ER. Zoom+ opened its Super clinic in August and recently expanded from 10 to 20 hours a day, opening at 6 a.m. and closing at 2 a.m.
Large markerboards inform the patient upfront about their diagnosis and recommended tests and procedures, and the Super clinic is able to conduct blood tests as well as imaging, starting with a non-invasive ultrasound and escalating to X-Ray and CT if necessary.
If a patient does need to be admitted to the hospital -- most commonly for appendicitis -- Zoom+ will arrange an admission directly to the hospital of the patient’s choice, allowing them to bypass the hospital emergency room.
Zoom+ positions their Super clinic near the Oregon Convention Center in Portland as a stand-alone emergency room -- a step above an urgent-care clinic, but a step below a true hospital emergency room.
They don’t treat trauma cases or most conditions that would require admission to the hospital. “We don’t get people bleeding to death from gunshot wounds -- we don’t get any of that,” said Tony Westover, the general manager of the Zoom+Super Clinic.
But with a CT scan machine and emergency room physicians on staff, 20 hours a day, they’re able to treat far more serious conditions than a same-day urgent care clinic.
Zoom+Super advertises treatment for “80 percent of the reasons that adults and kids go to the ER.” These symptoms include bone fractures, abdominal pain, asthma attacks, kidney stones and early pregnancy complications.
“We can treat the majority of emergency situations.” said Steve McCallion, the chief member officer for Zoom+. “If you think you need to go to the ER, but you’re not sure, you can come here. If you’re in the waiting room, you don’t need to be at the hospital.”
Zeitzer said that unlike the regular Zoom+ clinics, the Super does dispense narcotics, but prefers to give out non-addictive Toradol or Ketorolac for pain relief, and the clinic utilizes the Oregon Prescription Drug Monitoring Program each time it prescribes stronger medications. He hasn’t noticed any patients abusing the clinic as an excuse to get opioids.
The Super clinic also offers imaging-only services for $199, including X-Ray and ultrasound as well as computerized axial tomography, but not magnetic resonance imaging (MRI).
They arrive at their lower cost from two directions -- they don’t have the high cost of a large staff and large facility and try to pass that onto patients at the ER -- and the Zoom+ clinic lacks the leverage that hospitals can demand from insurers to extract payments far higher than the actual cost.
Praise and Criticism for Zoom+
Zoom+’s price transparency has won praise from health industry observers, even as the chain still faces criticism for not accepting all patients.
“ZoomCare posts their prices,” said John McConnell, a health economist at Oregon Health & Science University, at a recent discussion of health prices at an Oregon Health Forum breakfast. “I think that’s a step in the right direction.”
But Zoom+, formerly known as ZoomCare, has come under repeated criticism for not accepting coverage for Medicaid or Medicare -- roughly half of Oregon’s population. “You want accessibility and availability,” said Sen. Laurie Monnes Anderson, D-Gresham. “There has been concern with any clinic that’s seen as cherry-picking the wealthier patients.”
Unlike many states, Oregon’s Medicaid system has been managed well enough for 94 percent of primary care providers to accept the Oregon Health Plan -- but not ZoomCare.
A Zoom+ clinic in Seattle was recently picketed by healthcare activists and union members for its refusal to accept such coverage which generally offers lower reimbursement than commercial insurance..
Len Bergstein, the Zoom+ lobbyist, refutes the accusation that the clinic chain engages in “cherry-picking,” noting that they are merely focused on serving millennials and people in the middle of their lives, not older patients or complicated low-income patients.
“Some of the most well-financed parts of the system are focused on Medicare and Medicaid,” Bergstein said -- pointing to the hospital systems, which have a controlling interest in Health Share -- the state’s largest coordinated care organization, as well as several others.
