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Medical Business Model Trends, Part 3: Urgent Care

At their core, Urgent Care Clinics are alternatives to emergency rooms. They fill the gap between seeing one’s General Practitioner and going to the emergency room of a large hospital. Here’s a typical example: you need antibiotics for a sinus infection, but your doctor has no appointments available until next week, and you do not want to wait for many hours at a costly emergency room (or that emergency room is turning away patients because of COVID). Generally speaking, services offered at Urgent Care Clinics are short, on-demand, and (relatively) cheap:

  • 97% of urgent care patient encounters last one hour or less
  • In 92% of cases, the patient waited less than 30 minutes to see the doctor
  • A 2016 study found that ER treatment costs were about 10 times more than urgent care costs, even for the same procedures

Most clinics have a set of standardised services. They perform interventions for minor injuries, such as stitches, minor surgeries, sprains, and fractures. They also provide many services needed for work, such as workers’ comp and work injury care, EKGs, vaccinations, immunisations, and drug and alcohol screenings. Additionally, they help with infectious diseases, such as rapid testing for strep throat, flu, COVID. Generally speaking, urgent care clinics avoid offering any surgical services that require anaesthesia beyond topical. Thus, no one is put under, and they also do not provide medical services with lengthy recovery times. Moreover, they generally offer basic imaging, such as X-rays, but stop at more complex imaging, such as MRIs.

Industry Growth

As of 2013, the number of urgent care centres in the United States was 6,100. As of November 2019, the number was 9,600. Part of this growth is satisfaction: 98% of patients going to an urgent care centre are in the appropriate care setting, with only 2% being sent to an emergency room for care. These clinics are far more convenient than standard doctors’ offices; they are often referred to as “fast medicine”, an allusion to “fast food”. Concerta is America’s largest urgent care system. The company’s annual revenue exceeds 1 billion USD across their 500+ location in over 40 states. The company has over 12,000 employees, and before the pandemic, they were serving more than 30,000 patients per day. Their reach is so extensive that they treat about 1/7 of all workplace injuries in the US.

The UK also has a version of urgent care clinics, but they are not-for-profit institutions. Instead, they are clinics run by the NHS or hospital trusts known as “walk-in centres” and “minor injury units”. Anybody can go to an urgent treatment centre (UTC) if they need urgent medical attention that is not a life-threatening situation. UTCs are open at least 12 hours a day, every day. Thus, the conditions they treat are very similar to that of urgent care clinics in the US. But since they are not-for-profit, the main difference is the wait times. People in the UK complain of excessive wait times, whereas the American version of the business model emphasises extreme swiftness. According to industry studies, 92% of urgent care clinics maintained wait times of 30 minutes or less, and 57% of urgent care patients waited less than 15 minutes.

This business model has been highly profitable in the United States because of the strong demand for immediate, attentive care. Despite attempts in other nations, the model has not yet gained traction anywhere else to the extent it has within the States. COVID might be a game-changer: after years of cancelled procedures, long wait times, and overburdened public hospitals, more and more people may be ready for a drastic change in how they view healthcare services.

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Medical Business Model Trends, Part 2: Executive Physicals