25 Things to Know About Urgent Care

Urgent care centers — walk-in medical clinics that treat minor conditions such as sprains and colds, as well as conduct imaging and blood tests — have seen significant growth in recent years. Their lower costs compared with emergency departments and easy access have attracted both patients and investors as the industry looks for lower-cost options and resources to care for the nearly 30 million patients who will soon gain health insurance under the Patient Protection and Affordable Care Act. Here are 25 facts and statistics about the urgent care market.

1. There are approximately 9,000 urgent care centers in the U.S., according to the Urgent Care Association of America.1 In its 2012 survey of urgent care centers, 40 percent expected to expand their existing site or add another site.2

2. Seventy-five percent of urgent care centers are located in suburban areas, 15 percent in urban areas and 10 percent in rural areas.1

3. As of July, the 10 metro areas with the largest number of urgent care clinics are as follows, according to Merchant Medicine:3

•    Los Angeles-Long Beach-Santa Ana, Calif. — 164 clinics
•    Miami-Fort Lauderdale-Pompano Beach, Fla. — 107 clinics
•    Chicago-Naperville-Joliet, Ill.-Ind.-Wis. — 103 clinics
•    Dallas-Fort Worth-Arlington, Texas — 88 clinics
•    Atlanta-Sandy Springs-Marietta, Ga. — 84 clinics
•    Phoenix-Mesa-Scottsdale, Ariz. — 80 clinics
•    Detroit-Warren-Livonia, Mich. — 76 clinics
•    New York-Northern New Jersey-Long Island — 74 clinics
•    Houston-Sugar Land-Baytown, Texas — 68 clinics
•    Riverside-San Bernardino-Ontario, Calif. — 68 clinics

4. About half of urgent care centers are freestanding buildings, and the other half are in retail shopping centers, according to the National Association for Ambulatory Care.4

5. The majority of urgent care centers — 61 percent — have been in operation for more than five years,1 with approximately 40 percent open for nine years or more.2 Fifteen percent have operated for three to five years, 16 percent for one to two years and 8 percent for less than a year.1

6. Eighty-five percent of urgent care centers are open seven days a week, with 95 percent closing after 7 p.m.1

7. In 2012, an urgent care center had an average of 357 patient visits per week, which translates to more than 160 million total visits annually for all urgent care centers combined.1 This volume is an average increase of about 3 patients per day from 2010.2 In a 2012 survey of centers, more than 85 percent reported expecting growth, mainly in the number of visits.2

8. Sixty-nine percent of urgent care centers have wait times of less than 20 minutes, 28 percent have wait times between 21 and 40 minutes and 3 percent have more than a 40 minute-wait.1

9. The most common diagnosis in an urgent care center was upper respiratory condition, and the most common procedure was wound repair in 2012.2 Fewer than 4 percent of patients needed a transfer to an emergency room in 2012.2

10. An estimated 13.7 to 27.1 percent of all emergency department visits could take place at an urgent care center or a retail clinic, generating a potential cost savings of approximately $4.4 billion annually, according to a 2010 study in Health Affairs.5

11. A 2009 BMC Health Services Research study found 92.6 percent of centers provide some kind of occupational medicine services, 93.3 percent process some lab tests onsite, 80.7 percent offer fracture care, including splinting and casting, and 79.3 percent provide sports and school physicals.6

12. Approximately 20,000 physicians practice urgent care medicine, according to the American Academy of Urgent Care Medicine.7 The vast majority of centers — 94.1 percent — have at least one full-time employed physician on staff. The most common physician specialty is family medicine at 47.8 percent, followed by emergency medicine at 30.1 percent.1

13. Ninety-five percent of urgent care center physicians do not have and do not require hospital-admitting privileges, according to the National Association for Ambulatory Care.4

14. In 2010, the annual median compensation range for urgent care physicians was $170,000 to $179,000. Here is a breakdown of urgent care physician compensation for 2010, according to an Urgent Care Association of America survey:8

•    Less than $130,000 — 10.5 percent
•    $130,000 to $139,000 — 1.3 percent
•    $140,000 to $149,000 — 5.3 percent
•    $150,000 to $159,000 — 21.1 percent
•    $160,000 to $169,000 — 7.9 percent
•    $170,000 to $179,000 — 11.8 percent
•    $180,000 to $189,000 — 14.5 percent
•    $190,000 or more — 27.6 percent

15. A 2012 survey of urgent care clinics found the average annual expenses were slightly less than $2.3 million, the majority of which paid employees' salaries and benefits.2

16. Estimates of urgent care centers' total annual revenue range from $9.23 billion by Marketdata Enterprises9 to $14.5 billion by IBISWorld.10

17. In 2008, five primary payers reimbursed for urgent care center visits, according to an Urgent Care Association of America survey:11

•    51 percent of visits were reimbursed by private insurance
•    14 percent of visits were reimbursed by Medicare
•    13 percent of visits were reimbursed by occupational medicine (includes employer contracts and workers compensation)  
•    12 percent of visits were reimbursed by self-pay
•    10 percent of visits were reimbursed by Medicaid/public

18. The investment needed to open a stand-alone urgent care center with on-site X-ray machines and other equipment is $750,000 to $1 million, according to Marketdata Enterprises.9

19. There have been at least three major acquisitions in the urgent care market this year, including American Family Care's acquisition of Doctors Express in April, making AFC the second-largest privately owned urgent care operator after MedExpress with a total of 106 clinics as of Aug. 1. Also in April, CareSpot, in a joint venture with HCA Holdings' Brentwood, Tenn.-based TriStar Health, acquired NeighborMD's five clinics, and by the beginning of August, operated 45 clinics. Also in August, NextCare Holdings acquired 11 PrimaCare Medical Center locations, bringing its total to 86 clinics.

20. As of Aug. 1, the top 10 multistate urgent care operators include the following, according to Merchant Medicine:12

•    Concentra — 307 clinics
•    US HealthWorks — 145 clinics
•    MedExpress — 114 clinics
•    NextCare — 86 clinics
•    AFC Doctors Express — 69 clinics
•    FastMed — 54 clinics
•    Doctors Care — 52 clinics
•    Patient First — 46 clinics
•    CareSpot — 45 clinics
•    American Family Care — 37 clinics

21. Urgent care centers are an attractive investment opportunity. Private equity firms invested $4 billion in health and medical services, including urgent care, in 2012, compared with $3.5 billion in 2011, according to a Reuters report.13 For example, Brockway Moran & Partners invested growth capital in MD Now Medical Centers in April 2012, and Ridgemont Equity Partners acquired a majority stake in Hometown Urgent Care, which operates 25 clinics, in June 2012.

22. Payers and health systems have also invested in urgent care centers. In 2012, San Francisco-based Dignity Health bought the urgent care chain US HealthWorks, and in the same year LLR Partners and insurer WellPoint invested in urgent care clinic chain Physicians Immediate Care, which increased its number of clinics from 20 at the end of 2012 to 31 as of Aug. 1.

23. As of December 2012, the top 10 health system urgent care operators include the following, according to Merchant Medicine:14

•    Aurora Urgent Care (Milwaukee) — 37 clinics
•    Intermountain InstaCare (Salt Lake City) — 24 clinics
•    Carolinas HealthCare Urgent Care (Charlotte, N.C.) — 22 clinics
•    Florida Hospital CentraCare (Orlando) — 20 clinics
•    St. John Providence Urgent Care (Warren, Mich.) — 18 clinics
•    Norton Immediate Care (Louisville, Ky.) — 13 clinics
•    Health Partners Urgent Care (Bloomington, Minn.) — 12 clinics
•    Advocate Health Immediate Care (Downers Grove, Ill.) — 11 clinics
•    Marshfield (Wis.) Clinic Urgent Care — 11 clinics
•    Primary Health Urgent Care (Garden City, Idaho) — 10 clinics

24. Here is a breakdown of urgent care center ownership in 2012:1

•    35.4 percent of centers owned by physicians or physician groups, down from 50 percent in 2010
•    30.5 percent owned by a corporation, up from 13.5 percent in 2010
•    25.2 percent owned by a hospital
•    4.4 percent owned by a non-physician individual
•    2.2 percent owned by a franchise

In 2010, non-physician individuals, hospitals and franchises owned 7.7 percent of urgent care centers.15

25. One factor driving the growth of urgent care centers in the health reform era is their lower costs than emergency department visits. A 2009 Annals of Internal Medicine study found the overall cost of care for an urgent care center visit was $156, compared with $166 at physician offices and $570 at EDs.16  

 

 

Footnotes:

1 Urgent Care Association of America. "2012 Urgent Care Benchmarking Survey Results." Urgent Care Industry Information Kit. 2013. Available online at http://www.ucaoa.org/docs/UrgentCareMediaKit_2013.pdf

2 Urgent Care Association of America. "2012 Urgent Care Benchmarking Survey Results." Available online at http://www.ucaoa.org

3 Merchant Medicine. "The ConvUrgentCare Report." July 2013.

4 National Association for Ambulatory Care." About NAFAC." Available online at http://www.urgentcare.org/AboutNAFAC/tabid/131/Default.aspx

5 Weinick, R. M., Burns., R. M., and Mehrotra, A. "Many Emergency Department Visits Could Be Managed At Urgent Care Centers and Retail Clinics." Health Affairs. September 2010. Available online at http://content.healthaffairs.org/content/29/9/1630.abstract

6 Weinick, R. M., Bristol, S. J., and DesRoches, C. M. "Urgent Care Centers in the U.S.: Findings From a National Survey." BMC Health Services Research. May 2009. Available online at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2685126/

7 American Academy of Urgent Care Medicine. "About the AAUCM." Available online at http://www.aaucm.org/about/future/default.aspx

8 Urgent Care Association of America. "2010 Urgent Care Benchmarking Survey Results." Journal of Urgent Care Medicine. July/August 2011. Available online at http://jucm.com/magazine/issues/2011/0811/files/42.html

9 Marketdata Enterprises. "The Market for Retail Health Clinics & Urgent Care Centers." September 2012. Available online at http://www.prweb.com/releases/2012/9/prweb9931728.htm

10 IBISWorld. "Urgent Care Centers in the US: Market Research Report." February 2013. Available online at http://www.ibisworld.com/industry/urgent-care-centers.html

11 Urgent Care Association of America. "2008 Urgent Care Benchmarking Survey Results." Journal of Urgent Care Medicine. November 2009. Available online at http://jucm.com/magazine/issues/2009/1109/files/42.html

12 Merchant Medicine. "The ConvUrgentCare Report." August 2013.

13 Abrahamian, A. A. "Private equity funds rapid growth of walk-in clinics." Thomson Reuters. March 2013. Available online at http://www.reuters.com/article/2013/03/21/us-usa-health-clinics-idUSBRE92K04W20130321

14 Merchant Medicine. "The ConvUrgentCare Report." December 2012.

15 Urgent Care Association of America. "2010 Urgent Care Benchmarking Survey Results." Urgent Care Industry Information Kit. 2011. Available online at http://www.ucaoa.org/docs/UrgentCareMediaKit.pdf

16 Mehrotra, A., Liu, H., Adams, J., et. al. "Comparing Costs and Quality of Care at Retail Clinics with That of Other Medical Settings for 3 Common Illnesses." Annals of Internal Medicine. September 2009. Available online at http://annals.org/article.aspx?articleid=744702

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