The Growth and Success of Entrepreneurial Medicine- Urgent Care Centers

January 12, 2016

The start of the year often sees the beginning of new business models. And since we have become a national healthcare organization liability insurance agency, we have seen a lot of innovation in healthcare. From Florida to Washington state we see an increasing independence and partnering with mid-level providers. I wanted to take a moment to write about urgent care centers because this is the recent area of healthcare. 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. According to online news published by Becker Hospital News: Approximately 20,000 physicians practice urgent care medicine, according to the American Academy of Urgent Care Medicine - — 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 percent.

The urgent care (and retail, walk in clinic) care model seems to be meeting the three difficult tasks of reform which are the following:

  • increase access to care, reduce cost and increase quality.
  • Increased Access to care requires more healthcare providers and flexible scheduling:

Most urgent care centers follow a seven-day week, 12 hour day scheduling model. Even if those hours are cut, urgent care centers are always open in the evenings Monday through Friday and on Saturdays and Sundays. The presents a scheduling challenge. It is not required to have a medical doctor on site every day, however, most states require, and certainly best practices require, immediate availability and close and careful supervision. The Doctors Insurance Agency has been working for 20 years to design and to underwrite competitive urgent care policies. The primary issue with urgent care centers is to eliminate the high cost of tail when physicians or mid-level providers have to cancel off of the policy.

Lower Cost:

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 Emergency Departments.

Increase Hours, a flexible roster of physicians:

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. The physician salaries require approximately $ 150,000 to $ 200,000. (of course, many urgent care centers need more than one physician, full time on staff: and, with the increase of physicians, the patient population and revenue grows.

With urgent care centers, we see an increase in the number of hours which makes it easier for patients to get care -whether it is non-acute non-emergency care, or even wellness and primary care, patients are showing a preference to ‘walk in’ without the hassle and wait of appointments:

Entrepreneurial medical doctors are partnering with physician assistants, nurse practitioners and other credentialed nurses to provide access that simply did not exist before the introduction of these centers.

Structuring a medical malpractice insurance policy which allows for quick ‘onboarding’ of physicians without the prohibitively expensive tail encumbrance when they cancel is essential to the growth and success of these centers.

Working with The Doctors’ Company (the Nations’ Largest Medical Malpractice Insurance Agency (Doctor owned and operated) we can provide flexible policies which eliminate the tail cost and provide ongoing coverage to the physicians who leave – often for less than $ 5,000 per year for startup urgent care centers.

The strength of the Insurance Carrier is important because the value of the tail (payments and defense of claims going forward is only as credible as the financial integrity and strength of the insurance company behind it.

In Becker’s Hospital review they recently published 25 interesting facts about urgent care centers. 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 gain health insurance under the Patient Protection and Affordable Care Act. Here are 25 facts and statistics about the urgent care market.

An edited recounting of the points from the Hospital Review Article are below:

  1. There are approximately 9,000 urgent care centers in the U.S., according to the Urgent Care Association of America. In its 2012 survey of urgent care centers, 40 percent expected to expand their existing site or add another site.
  2. Seventy-five percent of urgent care centers are located in suburban areas, 15 percent in urban areas and 10 percent in rural areas.
  3. As of July, the 10 metro areas with the largest number of urgent care clinics are as follows, according to Merchant Medicine:
    • 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
  5. The majority of urgent care centers — 61 percent — have been in operation for more than five years
  6. Eighty-five percent of urgent care centers are open seven days a week, with 95 percent closing after 7 p.m.
  7. In 2012, more than 160 million people visited urgent care centers combined.
  8. Sixty-nine percent of urgent care centers have wait times of less than 20 minutes, with only 3 percent have more than a 40 minute-
  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.
  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

There are more interesting statistics about the benefits of opening a quality urgent care center. The Doctors’ Insurance Agency is proud of its long standing commitment to providing competitive, flexible policies that properly accommodate the need for tail insurance.