More urgent care chains have a triple-digit number of locations than ever before
December 2023- The Journal of Healthcare Contracting
The number of urgent care centers continues to rise. According to the Urgent Care Association, there are over 14,000 such centers in the U.S. (not including retail clinics), and the current growth rate for new ones is 7%. Over 78% of the U.S. population lives within a 10-minute drive of an urgent care center. As such, they represent a growing opportunity for distribution. And they’re getting bigger – through consolidation – all the time.
Urgent care bridges the gap between primary care and emergency care, providing evaluation and care for urgent, but not emergent, conditions, according to the UCA. This includes treating minor burns, scrapes and cuts, but also treating conditions such as allergic reactions, ear infections and strep throat. Care volume can be seasonal, typically spiking during late fall and winter, during the respiratory season, correlating to the intensity of the flu, COVID-19, RSV and other respiratory illnesses.
Most centers stabilize and treat fractures and offer onsite X-ray, laboratory and lab services. Where allowed by state law, many centers dispense commonly prescribed pre-packaged medications. They do not care for life- or limb-threatening situations but do stabilize patients while securing emergency transport. The majority of urgent care centers employ family practice and emergency medicine trained physicians, as well as licensed healthcare professionals, including physician assistants, nurse practitioners, registered nurses and radiology technicians.
Urgent care centers provide laboratory testing both onsite as well as those that can be sent out to regional or national laboratories, says UCA. Examples of available testing may include blood testing services such as Complete Blood Count, Comprehensive Metabolic Profile, diabetic testing (hemoglobin A1c, fingerstick glucose), urine pregnancy, urinalysis, rapid strep throat cultures, and rapid influenza testing. Centers also routinely offer tuberculosis testing; drug screens from urine, hair and saliva; and cultures for STIs and urinary tract infections.
Ownership trends
The urgent care industry’s ownership mix is in a constant state of flux, says UCA. These centers emerged largely as a physician or physician group strategy. In 2008, 54% of centers were physician-owned while hospitals represented 25% of the total. By 2014, physician ownership had dropped to 40% and hospital ownership increased to 37% of respondents.
In 2022, ownership by a physician was reported at 27%, while hospital owned/joint venture centers made up 53%. Corporate entity (private equity, insurance companies or majority shareholder ownership) was at 15%. One year later, sole ownership increased to its levels of nearly 15 years ago, at 52%. Hospital owned/JV growth dropped sharply, from 52% in 2022 to 33% in 2023.
Consolidation is growing in urgent care. “The ‘megacompanies’ owning urgent care is a relatively new phenomenon,” says Samantha Wulff, communications director for UCA. “What made it all possible was private equity interest. Scaling up in the industry requires a degree of standardization – everything from clinic layouts to staffing levels, and even where various supplies are stored. But it is a trend, with more urgent care chains having a triple-digit number of locations than ever before.” As far as integration goes, according to a 2019 UCA survey, nearly 60% of urgent care centers that are part of a larger health system said they intended to use the same electronic health record system as the hospital, she adds.
Sidebar 1:
Telemedicine and urgent care
Urgent care centers’ usage of telemedicine is growing. In the Urgent Care Association’s 2018 Benchmarking Report, only a small fraction of respondents (2%) stated that they offered telehealth services. Just one year later, the 2019 Benchmarking Report released in January 2020 showed the percentage of healthcare centers providing telemedicine grew to 29%.
The pandemic acted as a catalyst for the rapid adoption of telemedicine. In June 2020, 87% of healthcare centers were offering telemedicine services. By 2022, 94% were still offering it as a service. Patients have come to expect this service, according to the association. It is offered not because it is profitable, but to meet patient expectations and stay competitive. The dramatic increase clearly demonstrates the transformative impact of the pandemic on the widespread adoption of telemedicine within the healthcare industry, says UCA.
Sidebar 2:
Urgent care growth trends
COVID introduced many patients to urgent care for the first time, according to the Urgent Care Association. Pre-COVID, a single center saw 32 patients per day, on average. From 2019 to 2020, centers across the United States saw a 60% increase in per-center patient visits. Post-COVID, patients continue to recognize the importance of urgent care, says UCA. The median number of daily visits to a center was 40 in 2022. In fact, year-over-year urgent care center growth continues, as it has since 2014:
- 2014: 7,220 centers
- 2015: 7,983 centers
- 2016: 8,676 centers
- 2017: 9,553 centers
- 2018: 10,484 centers
- 2019: 11,481 centers
- 2020: 12,392 centers
- 2021: 13,306 centers
- 2022: 14,075 centers
- 2023: 14,382 centers
Sidebar 3:
Urgent care and the primary care doctor
Urgent care appears to be a young persons’ game, raising questions about the continuing role of primary care doctors in the health and well-being of Gen Z and Millennials.
Use of urgent care centers is much higher among Gen Z and Millennial consumers vs. other generations, with approximately 36% of them reporting having used urgent care services in the past six months, according to the Urgent Care Association. In comparison, only 19% of Boomers and members of the Silent Generation used urgent care during the same period. Meanwhile, Gen Z and Millennials have visited urgent care centers more frequently, with 56% and 45%, respectively, having visited more than three times in the prior 12 months, compared to only 26% and 22% of Boomers and Silent Gen.
“The goal of urgent care is not to replace primary or other specialized care,” says the UCA. “Urgent care centers are a perfect complement to the [patient-centered-medical-home] model, and they support primary care practices as an extension of the patient’s clinical team.”