Christopher Cheney, for HealthLeaders Media , November 30, 2015
Finance leaders need to consider a variety of metrics as health systems increasingly adopt strategies for urgent care.
This article appears in the November 2015 issue of HealthLeaders magazine.
As the healthcare industry shifts from service volume to service value, operating urgent care centers is emerging as a strategic imperative for health systems across the country.
“In the late 1970s and early ’80s, urgent care was a cottage industry that bloomed then faded. Urgent care is once again peaking,” says Sean McNeeley, MD, network medical director for Cleveland-based University Hospitals Urgent Care.
The University Hospitals health system operates 16 hospitals and more than 30 urgent care centers throughout northeast Ohio and reported total operating revenues of $3.5 billion in 2014.
Over the past three decades, UH has taken a do-it-yourself approach to developing urgent care centers, as opposed to building and operating the facilities with an urgent care organization partner, McNeeley says. “We have essentially followed urgent care as an industry.”
UH started riding the latest urgent care wave in 2000, when Lee Resnick, MD, a cofounder of the Naperville, Illinois–based Urgent Care Association of America, led an effort at UH to open new urgent care centers, McNeeley says, adding those efforts accelerated in 2008. “University Hospitals as a whole looked at access as part of its Vision 2010 initiative. … We started to expand urgent care to create greater access.”
Although the scope of services at UH urgent care centers has increased over the past 30 years to include services such as x-ray imaging and blood work, improving patient access remains a key goal in the health system’s strategic planning, he says. “We plan urgent care centers on access as the main criteria, making sure that we have our market share and that our footprint is where we want it.”
The emphasis on patient access at UH urgent care centers is reflected in the facilities’ open scheduling and business hours—from 9 a.m. to 9 p.m. on weekdays and 9 a.m. to 5 p.m. on weekends.
Assessing the financial impact of urgent care centers is as much art as it is science, McNeeley says. “It isn’t an easy mark.”
With low margins and high competition relative to emergency rooms, urgent care is rarely a major source of revenue for health systems. “In and of itself, you can’t expect an urgent care center to be a profit center, but it can produce sufficient downstream revenue. The goal is to be revenue neutral or net positive,” he says, noting that UH urgent care centers as a whole have been able to break even financially in recent years. “We have to see a significant number of people. You can’t do one patient an hour and survive in urgent care.”