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Twenty years ago, keeping non-emergent patients out of the emergency department was the differentiator that popularized urgent care. This included treating a lot of higher acuity patients, like those needing laceration repairs, casting, EKGs, fluid hydration, and other “complex” procedures. But this has changed over time.

A combination of factors has contributed to this shift, including a focus on seeing more patients per hour, bottlenecks resulting from COVID-19, and a trend to staff with more advanced practice providers (APPs) than ER doctors. (Get the data on these trends in Urgent Care Quarterly)

Consequently, urgent cares are passing up revenue opportunities — along with relevance as a go-to healthcare option for patients — and need to find a way to reverse course. For urgent care to remain competitive, the industry must retain its acuity edge. Fortunately, that simply means getting back to some basics.

We’ll cover four steps that can help you improve and leverage acuity.


Identify Opportunities and Create a Plan

Your first step is to review the type of high-acuity cases you feasibly could treat with the right resources. We provide a list of high-acuity services to consider in the next chapter, but we recommend you begin by reviewing what you’ve treated in the past and taking inventory on your current resources.

This will help you build out a tiered plan that will be easier to execute. You’ll not only need to train providers on skills and coding, but also front desk staff on the new cases you can accept – and not refer to a specialist. These things take time, so it may be wise to roll this out in phases.

Starting with what you have easiest access to and then building out from there may also help you be better positioned to invest in any equipment you need. If you’re making more revenue from higher acuity patients, you should be able to afford more down the road.

So sit down and answer some preliminary questions:

  • Are all your providers working at the top of their licenses? Who could be trained up?
  • What cases are you referring out that you don’t have to?
  • What equipment and services do you have access to that are underutilized?
  • Based on those answers, which high-acuity services would be easiest to revive or begin offering?

Once you’ve answered the “what,” you can focus on the “how.” Here are some things to keep in mind when building out your execution plan:

  • Get buy-in from staff: explain the value of what you’re doing and not only how it impacts your employees, but also how important their contributions are to your mission.
  • Choose a cadence that makes sense for your business based on bandwidth, cost, community needs/access, and learning curves.
  • Do your research ahead of time on anything you need to know to get reimbursed properly, including E/M codes, payer rules and restrictions, contracting and credentialing, etc.
  • Create metrics to gauge your success and identify how you can use your operating system to measure them.
  • Ask staff for frequent feedback so you can adjust your plan as needed going forward.

With a commitment to your plan, the number of high-acuity cases increases, especially among established patients, and reimbursement will begin to increase.


Train Staff to Treat Higher Acuity Patients

One of the reasons acuity has decreased in urgent care is because fewer ER physicians are utilized in this space. It’s simply less expensive to opt for other kinds of providers. According to Experity data, 84 percent of providers working in urgent care today are APPs, compared to 30 percent in 2009.

Urgent Care Provider Credential Distribution - Year over Year

Additionally, most nurse practitioners and physician assistants have a narrower skillset than physicians. But you can still take on higher acuity patients without hiring more physicians by training the providers you do have.

If you’re not sure what kind of training to consider, here are some examples of high-acuity cases that can be handled in urgent care:

  • Risk stratification of high-risk complaints like chest pain (history/physical/EKG/chest Xray)
  • Abdominal pain (history/physical/UA/labs)
  • Shortness of breath (history/physical /chest Xray /labs)
  • Head trauma (history/physical)
  • Syncope/dizziness (history/physical /blood sugar check/EKG)
  • Wound management and laceration repair
  • Abscess Incision and drainage
  • Eye injuries and irrigation
  • Severe nose bleeds (nasal packing placement)
  • Allergic reactions (Epinephrin administration)
  • Evaluation/Xray and splinting of sprains/strains/fractures
  • Advanced respiratory support for asthma and COPD (O2 therapy, nebulizer, medications)
  • IV therapy for dehydration, infections, migraines

With more trained providers, clinics can stop turning higher acuity cases over to the emergency department and provide the care urgent care patients are looking for.

Just remember that training is more than skills – include education around coding, intake questions, when to refer out, and anything else that could potentially impact quality of care or reimbursement.

Medical Professional Strategizing


Communicate to the Public

You won’t treat high-acuity cases if patients don’t know you can handle them. As with any new service line you provide, you need to use marketing to let your community know when to come to you.

The advantage you have here is that using urgent care over the ER is a no-brainer. According to, the average visit to urgent care costs between $100 and $150, whereas non-life-threatening issues can cost up to five times more at the emergency room.

The ability to save time and money should be central to your marketing campaigns. When it comes to building those out, you have both free and paid options.

Free(ish) Marketing

Most of these are technically not free, but rather use resources you already pay for like your website, internet, and patient engagement technology. Plus, we don’t want to undervalue your time.

That said, there is a lot you can do without shelling out more money.

Google My Business (GMB):

We hope everyone has a GMB account and someone who regularly updates it. It’s necessary to show up in a local search. Update your business description and any other fields that allow you to talk about new services. But be selective about what to spell out in your business description as people may not expand text to read it completely. Look at this example from Park Nicollet Urgent Care in Chanhassen, MN:

“The bumps in life never seem to follow a 9-5 schedule, so neither do we. Our urgent care center has you covered with walk-in visits and weekend hours. Urgent care is the best place to go for strep throat, stitches, sprains and strains. Check wait times online now.”

They identify a few higher-acuity cases that are also probably terms that a patient would Google for care options. If you have some sort of online queue available through your site, it is smart to highlight that as well.

Social Media:

Leverage your platforms to share “did you know” posts explaining what kinds of services you provide and the benefits of going to urgent care for these treatments. It may not be wise to share that you’ve just trained staff on these more complex cases, but you may be able to use photos from training to pair with your posts.

Sharing on social doesn’t just get the word out to your followers. It helps Google affiliate your business with the terms people are searching online.


Obviously, if you have a list of services/treatments on your site, update that as you train up. But you should do more to be found by patients and convince Google you’re an authority on those topics. Add informational blogs about the visits you can handle. Definitions, symptoms, treatments, and the like are common things you might find in urgent care blogs.

Note: if you use AI to save time writing blogs, know that you MUST check the copy for accuracy, and you will need to edit it to make it your own to remain consistent with your brand and avoid plagiarism.


If you’ve read our advice on startups or OccMed, those same grassroots efforts apply here. Join your local Chamber of Commerce. Reach out to surrounding businesses and schools, and form partnerships where it makes sense.

Patient Engagement:

If you have tech that can send emails to all your past patients, you have a valuable marketing tool. Use it to provide quick, helpful information that relates to your treatment capabilities. You can send checklists, blog teasers, symptoms to understand, and of course, thread in those major benefits of choosing urgent care over other options.

Paid Marketing

We won’t dive into all the traditional forms of marketing like billboards and other advertisements. If you’re using them, leverage them. There is one avenue we want to encourage you to explore if you have not already.

Paid Ads:

If you’re not using paid ads to target your audience online, know that we get consistent feedback from urgent care operators that they are well worth the money. There are even tools that let you target people at a specific location, like a baseball field for example, with a specific ad like where to go to treat injuries fast.

There are varying price points for paid ads, and a ton of tools available to help you be smarter about your efforts. But a great place to start is simply through GoogleAds.


Reduce Costs to Help With Your Transition

Equipment and training are, of course, not free. ROI will depend on how well you can prepare staff and communicate new services to the public. If cost is an immediate barrier to expanding your services, here are some potential ways to make room in your budget.

Fix What’s Broken

We preach about healthy revenue cycle management because many urgent cares don’t realize they’re losing money that can be easily recouped with a little digging. This is a larger topic that includes front desk processes, proper coding, and contracting/credentialing. We have several in-depth resources for you:

(Blog) Urgent Care Billing Optimization: How to Improve Your RCM

(Blog/PDF) Front Desk Checklist PDF for Better Urgent Care Billing

(Webinar on-demand) Hidden Revenue Cycle Mistakes That Hurt Most Urgent Cares

(Free service) Expert Billing Analysis

Reduce Labor Costs

Labor is the greatest cost you have in urgent care. Excess staffing is therefore something to avoid. Here is a brief overview of some ways you can right-size your staff.

  • Align patient-per-hour efficiencies with patient volumes
  • Staff to seasonal extremes not actual daily visits
  • Reduce headcount
    • Cross-training
      • NPs discharge patients
      • NPs become basic x-ray operators
      • MAs become basic x-ray operators
      • MAs work front desk
    • Augment with a bench of flex staff or PRN providers
    • Reduce hours on weekends
  • Uniforms provided vs. employees wear own scrubs (within standards)

We also expand on this topic in our eBook 6 Urgent Care Staffing Strategies to Protect Your Bottom Line

Medical Professional

Reduce Operating Expenses

We asked our consultant team for advice on cutting operating expenses. Here is an overview of some things you can look into right away to reduce your spend.

  • Supplies
    • Reduce formulary SKUs to essentials (eliminate duplicate items that perform the same function)
    • Reduce inventory levels (quantities) held in centers
    • Choose private label vs. branded product
    • Reduce order frequency (consolidate shipping)
    • Take advantage of group purchasing organizations (GPOs) and rebates
  • Occupancy expense
    • Renegotiate lease renewals to market rates
      • Ask for landlord flexibility in rent payment during slow periods
    • Evaluate contracts for cleaning services
      • For slow centers, have MAs clean and bring in a professional to clean at a reduced interval that makes sense for you
    • Implement process for maintenance calls (plumber, HVAC service, equipment etc.) such that staff can’t call without authorization
    • Evaluate purchased services for cheaper options
      • Bottled water vs. water filters
      • Shredding service vs. shredding machines
      • Printer/copier maintenance contracts vs. desktop 3-in-1s
      • Window washing vs. staff washing windows

Retaining acuity in urgent care does not mean reinventing the wheel. By going back to the core business basics, you can increase revenue and your impact on your community. And if you want a partner who can help you succeed, consider Experity. We’re more than a software company.