Sneak Peak! Urgent Care Quarterly: 2024 Revenue Trends

In the last issue of Urgent Care Quarterly, we explored how the operational strategies adopted by urgent care practices during the COVID pandemic had a profound effect on their success and longevity in a post-COVID healthcare reality. We shared the stories and recommendations of clinics that were able to drive their traditional urgent care business alongside COVID testing and treatment to thrive and grow. While average visits per clinic per day remain lower than pre-COVID levels, the market has stabilized with volume on par with 2023.

In the latest issue, we shift our focus to one of the biggest challenges for urgent cares today – revenue cycle management.

Urgent care has moved on from 2020’s public health emergency, but not without addressing the need to adapt to the resulting changes in patient expectations and the overall on-demand marketplace – including revenue cycle.

Urgent Care Data Trends

As summer begins, visit volume is trending down, following common visit trends over the last five years. The seven-day rolling average in mid-June 2024 was 25 visits per clinic per day, approximately 3% lower than this time last year.

Since the beginning of the year, COVID visits have decreased. During the last six months, only 52 percent of urgent care respiratory visits included flu or COVID tests. At the same time, other respiratory visits are higher than pre-pandemic levels. To be sure you are not passing up the opportunity to improve clinical care, providers should consider a flu or COVID test for patients presenting with respiratory complaints.

From a regional perspective, visits in the southern U.S. are lower on average than other parts of the country, while clinics in the West and Northeast are markedly higher. Over the last six months, clinics are seeing an average of 30 visits per clinic per day nationwide.

Net revenue per visit (NRPV) at the end of 2023 averaged $132, an increase of two percent (reflects visits with a 0 balance only.) As urgent care clinics return to traditional practices and encourage (and train) providers to avoid referring patients to the ER or specialists, and instead take advantage of tools like differential diagnosis to ensure they are including all complaints in their documentation, we will continue to see revenue per visit increase over time.

Four factors affecting your revenue cycle

We’ve identified four areas that have a direct impact on your revenue cycle:

1. Competition for urgent care dollars
   Retailers including Walgreens, CVS, Walmart, and Amazon launched in-store healthcare clinics and online services like telehealth to increase access to care, improve patient convenience and satisfaction, and to grow their financial footprint in the healthcare market. Telehealth fails and other less-than-successful efforts to jump into healthcare continue to prove that healthcare is a tough industry. Increased labor costs, inflation, and flat or declining payments from insurance payers make it challenging – but not impossible – to stay profitable. By expanding services in ways that make sense and continuing to improve the quality of care for patients, urgent care will continue to be the destination for on-demand healthcare services today’s patients prefer.
2. Process improvement
   There is no way to improve your performance without firm billing protocols. If you haven’t already, develop detailed standard operating procedures (SOP) to guide everyone in your clinic, preparing them to successfully navigate any situation that arises. When everyone in your clinic is on the same page, it’s easy to identify areas that need improvement and make necessary changes to remove roadblocks to better financial performance.
3. Payer Relationships
   Understanding and effectively managing payer contracts is essential for healthcare providers to ensure they receive fair compensation for their services and can continue to provide high-quality care to patients. The terms of payer contracts can significantly impact how healthcare services are delivered, as they determine how providers are compensated. Fair and well-negotiated contracts enable providers to offer quality care while maintaining financial health. Be sure you understand the fine print once contracts are in place and build a centralized system for managing them, so you’re prepared to renegotiate and achieve better terms.
4. Proactive planning and data security
   The last five years have opened our eyes to the importance of crisis and contingency planning. Few healthcare operators were prepared for the 2020 public health emergency. More recently, the cyberattack on Change Healthcare virtually stopped payments to physician practices shaking the stability of healthcare providers and impacting access to patient care. Practices will close because of this incident. Global health is unpredictable and cyberattacks on healthcare are increasingly sophisticated and dangerous. Set yourself up to weather coming storms with contingency plans and a focus on data security.

Revenue cycle management begins before patients enter the clinic and depends on keeping your eyes on your competition, assessing all processes for efficiency and accuracy, payer negotiations, a commitment to security and contingency planning, and an urgent care partner that is in alignment with your goals.

To access more 2024 data, get the full issue of Urgent Care Quarterly: 2024 Revenue Trends.

Download the Full UCQ