What is "Urgent Care" Anyway?

The Urgent Care Association (UCA) defines an urgent care center as a medical clinic with expanded hours that is specially equipped to diagnose and treat a broad spectrum of non-life or limb-threatening illnesses and injuries. Urgent care centers are enhanced by onsite radiology and laboratory services and operate in a location distinct from a freestanding or hospital-based emergency department. Urgent care centers accept unscheduled, walk-in patients seeking medical attention during all posted hours of operation.

No matter their size or locations, all Urgent Care clinics have four things in common:

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Lower Costs

Let’s face it, ERs are expensive. There are many reasons for the higher costs, ranging from equipment and staffing to lack of knowledge about you and your health history (which can lead to more tests). Insurance companies place greater restrictions on the use of emergency room visits to prevent unnecessarily expensive care. That means you could receive a substantial bill after your visit.

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Less Stress

The emergency room can be chaotic,
crowded and uncomfortable. Doctors, nurses and staff members are often rushed, leaving them less time to really talk with you and understand your situation. You might even be unsettled by the sounds of life-saving care in progress. Urgent Care clinics offer a much more relaxed care environment for both patients and staff.

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Less Waiting

Yes, ER staff are specially trained to move quickly. But if you’re not suffering from a traumatic or life-threatening issue, you’ll need to wait in line. Emergencies come first. Urgent Care clinics, on the other hand, allow you to be seen much faster.

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Convenience

Whereas your primary care provider’s office might only be open Monday through Friday, from 8am to 5pm, Urgent Care clinics are often open later in the evening and on the weekend. No appointment needed.

According to the Urgent Care Association (UCA) 2018 Benchmarking Report, nearly all urgent care visits are more convenient and affordable than a trip to the ER. The study found that more than 70% of patients waited less than 20 minutes to see a provider at an urgent care center, and nearly 94% were seen in less than 30 minutes. Overall, 85% of urgent care centers patients are taken care of in under an hour.

Emergency Rooms vs. Urgent Care Centers Patients can save time and money by choosing the right facility.

The History of Urgent Care

The first urgent cares opened in the United States in the 1970s. They sprung up as a way to serve patients quickly and conveniently, but they weren’t very common until the turn of the millennium.

The reported number of urgent care centers in the United States continues to increase year over year, with industry growth increasing by approximately 400-500 new centers per year.*

•    YR 2014 – 6,400 Centers
•    YR 2015 – 6,946 Centers
•    YR 2016 – 7,271 Centers
•    YR 2017 – 7,639 Centers

*The Essential Role of the Urgent Care Center in Population Health, Urgent Care Association White Paper 2018

The Evolution of Urgent Care Centers How they began and the factors that shaped them.

Staffing & Treatment Options

From the child with potential pink eye to a rolled ankle on your way to work, minor illnesses and injuries have a way of happening at the least convenient times. If you can’t wait to see your doctor – but you’d rather not wait for hours at an expensive ER – Urgent Care clinics are a smart option.

Urgent Care clinics are staffed with licensed medical professionals, just like you’d find at any hospital, primary care clinic or emergency room. Yes, Urgent Care doctors are good doctors! So are Urgent Care nurses, nurse practitioners, physician assistants (PAs) and technicians. The only difference is the types of care situations and treatment options an Urgent Care clinic is equipped to provide.

Urgent Care Situations

  • Allergies
  • Chest and head colds
  • Coughs
  • Cuts that might need stitches
  • Dizziness
  • Earaches
  • Fevers
  • Fracture care
  • Heat stroke and dehydration
  • Injections
  • Irritated red eyes
  • Minor asthma attacks
  • Minor burns
  • Nausea and vomiting
  • Pneumonia
  • Rashes
  • Strains and sprains
  • Strep and sore throat
  • Urinary tract infections

Emergency Situations

  • Chest pain, numbness in face, arm or leg, or difficulty speaking
  • Coughing up or vomiting blood
  • Head injury with loss of consciousness
  • Heart attack
  • High fever with stiff neck, mental confusion or difficulty breathing
  • Inability to urinate
  • Life-threatening or disabling conditions
  • Severe shortness of breath
  • Sudden or unexplained loss of consciousness
  • Symptoms of stroke
  • Wounds that will not stop bleeding

The Bottom Line: Insurance & Out-of-Pocket Costs

How much does it cost to visit an urgent care center? Well, that depends on whether you've met your deductible, how much your co-pay is, whether the urgent care center is in or out of network, and any number of other factors.

But what’s for certain is that cost control is a huge issue when it comes to today’s healthcare landscape – for both patients and providers – and urgent care centers can go a long way to keeping quality care affordable.

  • Urgent care centers are definitely less expensive than an ER visit. In fact, a recent JAMA Internal Medicine report shows that the price of a visit to an urgent care center declined slightly from $165 in 2008 to $162 in 2015. What’s more, a 2016 study in the Annals of Emergency Medicine found that ER treatment costs were about 10 times more (an average of about $2,200) than in an urgent care center (about $168) when compared for patients with the same diagnosis.
  • Urgent care visits are covered by most insurance, but you don’t need to have insurance to visit an urgent care clinic. According to a November 2018 UCA survey, just under half (47%) of the patients seen in urgent care centers are covered by commercial insurance – and 27% are covered by either Medicare or Medicaid.

Costs at an urgent care center will vary greatly, depending on whether you receive care as an insured patient or an uninsured patient. However, you will pay for the cost of the visit itself as well as the cost of any additional services, tests and treatments. These could include:


Medications, injections and IVs

Tests and X-rays

Casting or bracing bones

Urgent Care is Big Business

Urgent care center business models vary as much as their patients and locations but tend to be either physician-owned (as a cost-effective way to build a patient base) or a “mixed model” with a balance of physicians, physician assistants, nurse practitioners and mid-level staff.
 
Do your research into who owns the urgent care center you’re considering. Urgent care centers can be owned and managed by private companies, health care organizations, health insurance plans and even by private equity investors. At least three organizations offer certification and accreditation programs for urgent care centers.

  • The Urgent Care Association of America has two levels: certification and, for centers that meet more requirements, accreditation. A UCAOA-certified center has met a list of criteria and has a scope of practice that meets standards of easy access and services that allow for care of a broad spectrum of illness, injury, or disease. Since 2009, 750 centers have been certified nationwide. An increasing number of payers are now accepting the designation in lieu of their own credentialing processes or onsite surveys, according to the UCAOA.
  • The second level, UCAOA accreditation, means the urgent care center has met certification criteria for scope of services and accreditation standards of quality and safety, and has received ratings of excellence in categories such as governance, human resources, and patient-care processes.
  • The Joint Commission also accredits urgent care centers under an umbrella that includes a variety of ambulatory care settings. These standards address emergency management, human resources, infection prevention and control, information management, and medication management.

The American Academy of Urgent Care Medicine also accredits urgent care centers. Centers must submit to
an onsite survey and must be under direction or supervision of a physician who accepts responsibility for the medical practice.

According to Business Insider, some of the largest US urgent care providers include:

  • American Family Care 
  • City MD 
  • Concentra 
  • Fast Med 
  • GoHealth 
  • HCA CareNow 
  • MedPost 
  • NextCare 
  • Patient First 
  • U.S. Healthworks

The Future of Urgent Care

For an industry built upon convenience and affordability, it’s hard to imagine the $18 billion urgent care industry slowing down anytime soon. In fact, it’s projected to grow 5.8% annually through 2018.1

Laurel Stoimenoff, CEO of UCA, says that urgent care clinics handle about 89 million patient visits each year, which includes more than 29% of all primary care visits in the US, and nearly 15% of all outpatient physician visits.

"Urgent care centers play an increasingly vital role in the continuum of care, providing services for a wide array of patients who may be unable to see a primary care physician for various reasons, including simply not yet affiliating with one." - Stoimenoff

So, how will urgent care help you in the future? The sky is the limit. Watch for more evolution of business styles and technology offerings, including:

  • Expanded services to better match the high-cost, long-wait ER model
  • More franchising models
  • Increased emphasis on branding and consumer-oriented healthcare experiences
  • Evolving services to better serve Baby Boomers aging into Medicare
  • Emerging telehealth options

“As urgent care becomes more integrated into mainstream healthcare delivery and technology, patients and providers will enjoy enhanced coordination of care and improved outcomes,” Urgent Care Association of America past president Dr. Nate Newman said in a statement accompanying a report he wrote on “patient-centric" healthcare.  

Urgent Care Trends to Watch in 2019 1HarrisWilliams&Co, Urgent Care Industry Overview, Sept 2013

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