Urgent Care Quarterly - COVID-19 Reimbursement Issue - Header

Experity is excited to launch the next issue of the Urgent Care Quarterly – How COVID-19 Affected Urgent Care Reimbursement in 2020. Since the beginning of the COVID-19 outbreak, our data team has been collecting information on visit volume, testing trends, vaccinations, and reimbursement to provide a broad view of what urgent care looks like in the new era of urgent care.

In the coming issue of Urgent Care Quarterly, Experity’s expert data and financial teams deep dive into the effect the pandemic had on urgent care financials coast to coast. The following is a short summary of what we found.

COVID-19 changed urgent care in ways we never imagined and challenged the way we deliver on-demand healthcare. Providers were forced to look at operations in new ways, to stay profitable and provide the care patients need – especially in trying times.

While urgent care providers were challenged by the lack of available personal protective equipment (PPE), everchanging COVID-19 information and regulations, and visit volume peaks and valleys, it was difficult to navigate the financial landscape and stay profitable.

Fluctuating Revenue Throughout 2020

The beginning of this pandemic in the U.S. sent urgent care visit volume and revenue plummeting. According to Experity data reported in the Urgent Care Quarterly Pandemic Issue, average urgent care visits per day at the beginning of March were slightly higher than the three-year average for 2017-2019. But within weeks of the Public Health Emergency declaration on January 31, 2020, volume reached its lowest point for the year on April 19, with an average of 16 visits per day. Along with this drop in volume, overall revenue began to drop.

But in July, as more tests and PPE became available, patients began to return to urgent care in unprecedented numbers. With this volume rebound, reimbursement for COVID-19 testing and telemedicine utilization created new challenges.

Decreases in visit volume at the beginning of the pandemic negatively affected revenue through mid-year. But as patients began to return to urgent care and COVID-19 testing ramped up, clinics were seeing a significant increase in patients which helped to offset earlier losses. Clinics experienced record-setting patient volume in Q3 and Q4, and by the end of the year, average patients per clinic per day for 2020 was 58% higher than the three-year average.

Higher Average Reimbursement per Visit

Despite the challenges of the pandemic and with 70 percent of all visits related to testing and COVID-19 symptoms, there was modest growth in average reimbursement per visit in 2020 versus 2019. (See Figure A.)

Average Revenue Per Visit Year Over Year - Urgent Care Quarterly - Figure A

Some urgent care clinics were not able to realize this modest growth over the year. Shrinking visit volumes during the beginning of the year led to limited hours and temporary or permanent closures.  Recouping financial losses that resulted from these closures had longer term effects on their bottom line through the year.

Average Revenue Per Visit Year Over Year by Segment - Urgent Care Quarterly - Figure B

MORE NEW PATIENTS

Patients visited urgent care in record numbers in 2020, so we looked at how many of those patients were new versus established. Our data indicates that the number of new patients grew significantly, from 39 percent of total volume to nearly half of all visits.  (See Figure C.)

New Patients Year Over Year - Urgent Care Quarterly - Figure C

COVID-19’s EFFECT ON COLLECTIONS

Did higher visit volumes combined with staff shortages (due to COVID-19 infection, quarantine, and the mental and physical health of staff) slow down the revenue cycle for urgent care clinics? With more clinic staff focused on patient care, and less attention paid to claims processing, we thought it would be interesting to compare reimbursement trends for clinics that used Experity’s external billing services versus non-Experity billing services clinics.

On average for 2020, average days in A/R for all claims was 43.82 days. Average days in A/R for Experity Billing Services clinic claims was 35 days versus 47.24 days for non-Experity Billing Services claims. (See Figure D.)

Average Days in A/R - Urgent Care Quarterly - Figure D

Collecting reimbursement was affected by a number of challenges throughout 2020 including changing and retroactive regulations, claims for uninsured patients, and an overall sense of confusion about who was responsible for COVID-19 related healthcare services.

The Takeaway

2020 was a challenging and memorable year for urgent care clinics across the country. The COVID-19 pandemic has stress-tested clinics to their financial and physical limits. Constant ups and downs in visit volume had a major impact on revenue but as always, have weathered the storm.

While visit volumes related to COVID-19 continue to decline, urgent care clinics are still seeing a healthy volume of 35 patients a day on average through the first quarter of 2021—eight percent higher than the three-year average. Some clinics that used an external billing provider told us they experienced less stress on their organizations with more time to focus on patient care and their pandemic response. As healthcare providers fought the outbreak on the front lines, their billing companies worked behind the scenes to stay informed about the constant coding changes and keep claims moving through the process.

At Experity, our entire team pulled together to provide technology resources and the most up-to-date information for our partners and the industry at large through constant communication and data-driven content to help them make the best possible decisions based on the fluid public health emergency.

We explore all the reimbursement data in the upcoming issue of Urgent Care Quarterly. Coming soon. Don’t miss it.

Unlock The Full Issue

Download the full report today and discover how COVID-19 affected urgent care reimbursement trends and see how your clinic stacks up.

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