Top 12 Factors to Consider When Starting an Urgent Care

The overused cliché aside, this is the most important (and fortunately, the first) step in the process. There are actually three major qualities in a successful urgent care site.

The site needs to be retail-centric, preferably grocery-anchored. The building, or at the very least, the sign, should be highly visible from the nearest major roadway.

The right stuff…demographics, that is. Urgent care services are sought out and used largely by those with private medical insurance. For this reason, the target user is the middle-class family; a successful urgent care is well-placed in family-friendly neighborhoods and suburbs.

There also needs to be enough patients to go around. As urgent care services don’t vary greatly from clinic to clinic or brand to brand, it is hard to overcome competition based on being “better”. The most effective way to guarantee satisfactory patient volume is to choose a location that is not directly competing for another urgent care’s patient catchment.

Compliance rules! Knowing the rules to OSHA, HIPAA and CLIA compliance is absolutely necessary. The programs are federally mandated and expectations are consistent nationwide.

It’s urgent care, not Amazon. Unlike the mammoth online retailer, urgent cares offer a relatively small subsect of medical services, and service delivery is far more efficient than Amazon’s 2-day shipping.

The urgent care setting is targeting patients seeking low acuity, yet immediate medical attention. Determine the services spectrum early on in planning, as these decisions have ripple effects to other aspects of clinic development.

Just as the business plan has been carefully laid out, attention must be paid to the configuration of the clinic. Some ancillary services may require specific plumbing, electrical or other needs that are best taken care of in the construction phase. A clinic footprint that allows for efficient patient throughput and operational workflow is very important.

When preparing the equipment list, be sure to account for all services offered in the clinic. This is also a good time to verify that all planned services will be reimbursed at profitable rates. In this day and age, a digital radiology suite is the only way to go. It offers higher quality images, ease of transmission and obtaining highest level of reimbursements. In 2017, payors started discounting payments for imaging done on CR machines. Additionally, it may not be wise to purchase and staff for higher level imaging, labs, procedures, etc., if the majority of the payor contracts are case rate.

Prove that this business is profitable, and how. Preparing a financial pro forma is critical. This document will be used to determine startup costs, on-going operational expenses and revenue projections.

A corresponding business plan is beneficial for presenting the project to potential investors or lending institutions.

If one references a “How to” list for starting an urgent care, there is a high probability of use of Policy and Procedure manuals in subject urgent care. A series of manuals that address all aspects of procedural expectations in the urgent care setting are worth their weight in gold.

Staff for the clinic should be considered carefully in the early days. As the patient volume will steadily grow over time, initially the minimum staff requirements far exceed the patient volumes. Be sure to use payroll hours carefully and cross-train staff members to maximize efficiencies.

The need, or perceived need for accreditation. In many cases, pursuing accreditation for a new center is an extraordinary (and costly) feat. That said, in some states, the insurance companies are dictating the need for accreditation in order to obtain contracts. While it presently is not necessary to spend early dollars and hours seeking this prestigious designation, there may be a shift coming sooner, rather than later.

If you build it, they will come. That’s a nice thought, Ray, but you’ll also need to deploy an effective marketing campaign to let the neighbors know you’ve arrived. A marketing plan includes print and online advertisements, timely signage at the site, connecting with local primary care physicians for their patient’s after-hours needs and a whole lot of hype.

Finally, selecting an EMR vendor and billing services provider are large and lasting decisions. Be sure to determine that your choice software vendor can meet the specific needs of your clinic, especially if offering ancillary services, such as occupational medicine. Another note on this, often contracting and credentialing services are offered as an additional amenity through billing companies. This means that you’ll be making this decision relatively early on in the process, as the contracting and credentialing process could take up to eight months. Upon determining who the medical director will be, the exact address of the clinic and securing the tax ID number, you’ll be ready to get started on this journey.

This resource was first published prior to the 2019 merger between DocuTAP and Practice Velocity. The content reflects our legacy brands.