Urgent care clinics have been a staple in outpatient healthcare for more than 20 years. They offer a happy medium between a primary care physician's office visit and the emergency room, and most treat adults and children. That utility has paid off in terms of growth. According to the Urgent Care Association (UCA), there were 8,774 clinics in the United States in 2018, up from 6,100 just five years earlier.
More recently, urgent care clinics have become the frontline for COVID-19 testing. The UCA said clinic visits jumped nearly ten percent in October 2020 compared to September 2020.
But will this sharp rise in patient volume have a lasting effect once the pandemic is behind us? What can urgent care clinics do to ensure they remain relevant, in-demand, and financially stable in a post-COVID-19 world?
For answers, we turned to Christopher Barnett, Senior Vice President of Operations, and Becky Tucker, Vice President, Client Services, who work with SCP clients managing urgent care operations in Florida and Georgia. Read on for the highlights of our conversation.
1. Offer an Excellent Patient Experience
"Patient-friendly" was a term both Barnett and Tucker repeatedly used during the call. Because urgent care clinics deal with consumers directly—not unlike retail—ensuring patient experience excellence is vital to the industry's sustained success.
Convenience is another term that enters into the urgent care lexicon regarding patient experience. It is a significant theme that governs much of how clinics operate, which is why you find them in easily accessible stand-alone locations or strip malls. Also, their operating hours span from morning to evening, often 10 a.m. to 10 p.m. Tucker said, and it's not unusual to see some open as early as 7 a.m. and close at midnight.
The need for convenience has not only influenced urgent care clinic locations and operating hours but also their use of technology as a way to reduce friction. Online appointment setting has become a standard to decrease wait times and minimize the number of patients that present and leave without treatment due to overcrowding or delays.
"As programs have matured, just like restaurants, urgent care clinics have begun using online reservations, so patients aren't left waiting to be seen," Barnett said. "They have also implemented the use of two-way communications via text and phone to help patients engage with registration and figure out wait times."
"Patients can also notify the facility when they arrive," Tucker added, remarking that some clinics are "actually going to the cars to see patients, especially those presenting with COVID-19 symptoms." (Urgent care clinics have less waiting room space than emergency departments to ensure social distancing, she noted.)
Diagnostics is another area where urgent care has gained a technological advantage. Tucker said that advanced imaging allows immediate access to radiological results, so patients no longer have to wait 24 hours to receive a report.
"You expect that in the ED, but don't anticipate it in an outpatient setting," she said, adding that "the technology has been there but hasn't been utilized in urgent care to the extent that it is now."
2. Ensure Operational Efficiency
Convenience and patient-friendliness also govern patient flow, a factor that has become increasingly important with the rise in volume due to the need for COVID-19 testing.
"Throughput matters," Barnett emphasized. "Moving patients through quickly is a big concern. Once we register patients and billing issues are taken care of, we get them into a room as quickly as possible. That way, they feel like they are in the process and the chances of them leaving are much less."
Tucker concurred: "Efficiency is a key issue. When you have a slower provider, you face the same issues EDs have dealt with over the years regarding patients leaving without a complete evaluation or treatment."
Tucker indicated some urgent cares have established protocols for the most common patient presentations to solve that problem. That way, when a provider is attending to one patient, nurses can start the intervention on the next.
"Urgent care clinics have a narrower scope of presentations than emergency departments, so it’s easier to set protocols," Tucker said. "Also, you tend to have more consistent staffing in urgent care than you have in the ED. There's less turnover, and everyone knows their role in taking care of patients."
Right-sizing staff is another factor in ensuring things go smoothly.
"During COVID-19, clinics are seeing patients arriving earlier rather than later," Barnett said.
"From a staffing perspective, they need to ensure they have the right number of resources available when the volume is there."
3. Promote Financial Sustainability
Because urgent care clinics are consumer-facing, they bear a strong resemblance to retail—and just as with retail, price-shopping is common.
Unlike emergency departments, urgent care uses a front-end revenue cycle model, which means the patient pays a portion of the charges upfront. That's another area where technology plays a significant role.
Real-time verification can verify coverage, determine patient responsibility, and ask for a percentage of the charge before the patient leaves the clinic. The more money collected at the time of the visit, the less time and energy are required during the billing process.
However, the ability to assess financial coverage and responsibility in real-time at the outset is a double-edged sword.
"Patients are more concerned about the amount of the bill than they are with the ED," Barnett said. "As deductibles increase, people are more price-conscious. They want to understand their financial exposure and are calling ahead to find out what the charges will be."
The experience patients have with the financial aspect of the clinic visit weighs heavily on their overall satisfaction. A bad experience can lead a patient to post a negative online review, for example, a vulnerability that could leave a mark on a clinic's reputation within the community.
Urgent Care Payor Mix & Demographics
The upfront nature of urgent care finances dictates the demographics of their patient population. Medicare and private insurance are the primary revenue drivers.
"Ideally, you're looking for a payor mix population consisting of the elderly and those employed with private insurance," Barnett said.
Demographically, millennials make up a quarter of all visits to urgent care clinics, according to a 2015 PNC Healthcare consumer survey. HealthLeaders Media says the 31- to 40-year-old demographic accounted for 18 percent of claims among patients using urgent care centers. Baby Boomers taking advantage of their newly-acquired Medicare benefits comprise another sizable group, the Journal of Urgent Care Medicine reports.
Telemedicine a Revenue Threat
Barnett sees telemedicine as the biggest threat to the urgent care industry's financial stability.
"Thanks to the pandemic, telemedicine is in use much more frequently," Barnett said. "If you are a low-acuity patient, the doctor can see you from your home. As people get more comfortable with telemedicine, it may decrease the use of urgent care. Plus, telemedicine is cheaper. That said, there are only so many things you can do virtually, so there will always be a need for urgent care."
Final Words of Advice
"We saw the boom of urgent care 20 years ago, but in a post-COVID-19 world, even after folks have become comfortable with telemedicine, there is still the opportunity for urgent care to co-exist," Barnett said. "It's a consumer-driven market. Patients have choices, and they opt for the one they determine is the best. Having the right location and the right patient interaction will drive patients to your front door—and keep them coming back for future needs."
Tucker summarized the main points of the conversation succinctly: "Align your hours with the patient volume to ensure you're available and accessible when needed, and make sure patients have a thorough, efficient experience."
Interested in learning about how SCP Health can support the clinical and operational success of your Urgent Care program? Contact us today.