Revenue challenges in urgent care aren’t always dramatic — but they’re often persistent. Whether volumes dip unexpectedly, payer mix shifts, or a typically busy season underperforms, your bottom line can feel the impact. In times of uncertainty, it’s easy to overcorrect — but smarter, more strategic adjustments can preserve both your operations and patient experience.
This guide is built to help you navigate those moments with confidence. Here are five common revenue challenges urgent cares face and the steps you can take to address them without making costly or reactionary cuts.
Before you analyze expenses or consider making major changes to your business, ensure you’re getting the money you are owed. Most urgent cares don’t realize they’re losing money to poor processes (like lack of follow-up calls on collections), costly missteps (like improper contracting and credentialing), inaccurate coding, and more. So along with improved tracking and visibility into your metrics, you want to investigate where you’re losing money that you already made.
If you don’t have a regular weekly or monthly cadence of running reports to see where you’re at, it’s important to do so. You should be analyzing denial and rejection rates/reasons, E/M weights, and contracting/credentialing requirements. You should also be on top of renegotiating payer contracts. It’s also a good time to review the software you’re using to make sure it’s providing accuracy and coding guidance.
DON’T
Problems begin on the front end of the billing process, so don’t rely solely on the back end for answers. And where you find problems, don’t expect your staff to correct themselves without some guidance, training, and clear/accessible/documented protocols.
If you’re not an expert at analytics, or you just don’t want to miss anything, the best thing to do for yourself is get a free billing analysis from Experity. We’re here to help you determine the health of your revenue cycle and identify opportunities for improvement. Without obligation.
Not ready to bring in an expert? You can also take this billing eval to see where you stand against industry benchmarks and where you may need the most help.
OTHER RESOURCES
The Front Desk Checklist PDF in this blog can help staff avoid missing steps that lead to rejections or denials.
Get advice on contracting and credentialing, how to improve eligibility for faster claims, and more based on gaps found in hundreds of billing audits. Watch Hidden Revenue Cycle Mistakes That Hurt Most Urgent Cares on-demand.
Learn how operating procedures contribute to rejections and denials in our on-demand webinar, Decreasing Denials & Rejections Through Your Urgent Care Operating Model.
Visit volume highs and lows are part of urgent care, but when predictable highs (like flu season) don’t pan out, it can strongly impact your yearly revenue. Compensating for unexpected lows means rethinking how you can get patients in the door more consistently year-round.
Consider adding convenience services (like medication dispensing), adding additional services (like OccMed or specialist services like ortho — even a day or two a week), and make sure that your existing services (e.g., X-ray and labs) are being utilized. Also, when choosing a new service line, check that your existing tech can support it without a huge investment (or that using separate tech won’t create problems for other workflows).
DON’T
It’s tempting to chase trendy new service lines to reach more people, but be careful not to add something — medspa treatments, for example — if you’re in a market already saturated with these services, and don’t choose something that veers away from what makes you you. Identify what you’re really good at and why people choose you, and find a service that fits with that brand/culture.
Learn How to Treat Higher Acuity Patients
As for selecting the types of services you want to add, and how to effectively market them, download the eBook How to Market and Diversify Your Services to Your Community. This eBook explores how different generations engage with urgent care — what draws them in, what keeps them away, and what services they’re most likely to use. You’ll also get tips for tailoring your offerings and marketing strategy to attract patients across age groups and even pull volume from the ED.
OTHER RESOURCES
Alan Ayers, Experity’s President of Consulting, walks through additional service lines and other growth opportunities in the webinar Urgent Care in the Post-Pandemic World.
For all our best resources and advice on marketing, SEO, and everything else that attracts and retains patients, check out our page on patient acquisition and retention.
Labor is not only a fixed cost in urgent care, it’s also your highest cost. Which creates a major revenue problem when you schedule excess staff compared to visit volume — especially if you do so frequently.
DO
A profitable urgent care center will adjust its staffing levels to revenue. Reduce headcount by considering:
DON’T
There are absolutely cases when volume is slow enough that a 1:1 staffing model is a good fit. Don’t hesitate to ask providers to step in and take vitals, draw blood, run rapid tests, and in some states, take x-rays so that you can cover all duties with a skeleton crew.
Rightsize staffing to demand. Make sure everyone practices at the top of their license:
As Alan Ayers says:
An “optimized” center would have: 1 provider, 2 MAs, an MA/RT and FOS. Cross-training the front and back office enables greater flexibility as does a local footprint enabling a “bench” of on-call, travel, flexi or PRN staff to fill-in as needed.
For less than 20 patients per day (1.6 patients per hour), a lot of UCs can get by with a 1:1 staffing model, at least at slower times.
We discuss lean staffing and rightsizing in our eBook 6 Urgent Care Staffing Strategies to Protect Your Bottom Line.
Get the eBook on Staffing Strategies
OTHER RESOURCES
Ayers goes into more detail on crafting the right staffing model in his JUCM article Tightening the Belt: Rethinking Costs and Efficiency in Urgent Care.
Outside of labor, what does it take to run your urgent care? Obviously, you don’t want to sacrifice quality when it comes to things that lend to the patient experience. But there are plenty of expenses you can evaluate to cut costs.
DO
Find opportunities with supplies and purchased services. Even if it’s less than 15% of total costs, contracts for janitorial services, window washing, mobile shredding, entry mats, water coolers, security systems, medical waste pickup, subscriptions and cell phone expenses can really add up!
DON’T
Your technology is likely among your highest-cost services, but don’t be too quick switch to a cheaper EMR, billing service, or other solution. You must weigh the true cost of making such a switch, like the time and pain of implementation/education, losing efficiencies that will hurt your operation in other ways, added duties for people without the right expertise to carry them out…a quick “fix” like this can lead to disaster later. Talk to your vendor to make sure you’re reaping all the benefits from your system — you may also not be using your tech to its fullest capability, which can impact your bottom line. If you’re an Experity customer, connect with your Client Success Manager to ask about features you may not be leveraging.
FASTEST REMEDY
Again, we rely on the advice of Alan Ayers. Here is his list of suggestions
to reduce operating expenses:
It’s tough to know where to begin reducing costs if you don’t use your data. For example, if you’re not tracking visit volume trends, it will be very difficult to correctly rightsize your staff. Without data, you risk blindly “correcting” areas that are not problematic while ignoring areas that need dire attention.
DO
Figure out which reports need to be run daily, weekly, monthly, quarterly, etc. Make a plan and be consistent. Your data is in your PM to help you. Use it!
DON’T
Running reports don’t mean much if you aren’t tracking and measuring your data. Don’t simply read reports and not track/
document the information against your KPIs.
If you’re not sure where to start with tracking KPIs, download this PDF that outlines the ten metrics that matter most and how to measure each.
OTHER RESOURCES
Dive deeper into the metrics to understand them more thoroughly
with our on-demand webinar KPIs to Measure in Your Urgent Care.
Get measurable results with software and services that take the complexity out of healthcare.
