Unlocking success: Examining urgent cares’ post-pandemic strategies

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Since the conclusion of the Public Health Emergency (PHE), urgent care (UC) clinics have struggled with new challenges, specifically decreased visit volumes, staffing issues, and surviving amid the overall economic downturn. The first three quarters of 2023 brought visit volumes below historical benchmarks, coupled with changes to payer guidelines and a concerning rise in claim rejections or denials from 2019. The uncertainty in the UC market has left many owners and operators contemplating the viability of keeping their practices open.

A growing issue in the healthcare industry is the overcrowding of emergency rooms, as seen at Massachusetts General Hospital, which declared a 'capacity disaster' in the emergency department late last year after reporting 86 patients waiting for a bed at one point. Burnt-out providers are burdened with this heavy demand, jeopardizing their well-being as well as patient care. When it comes to alleviating these strains, urgent care clinics play a pivotal role.

Urgent care clinics can optimize their ability to thrive by meeting this growing need, simultaneously mitigating some of the challenges they’ve faced since the pandemic. There is a real opportunity for them to play a crucial role in the healthcare ecosystem, helping restore balance that is long overdue and in turn bolstering their own viability.

UC management: Rising to the occasion or staying the course

In 2021, urgent care clinics across the U.S. stepped up during the PHE, showcasing flexibility and efficiency by swiftly administering COVID tests on a large scale while minimizing patient risk. As leaders took charge to curb the spread of the virus, many clinics shifted away from fundamental urgent care operational strategies, adopting a short-sighted "COVID-first'' approach. This strategy included a focus on high-volume COVID testing at the expense of higher acuity visits, reducing operational hours, backfilling less experienced practitioners, referring patients to the ER for complex cases, discontinuing x-ray services due to radiologist shortages, and pivoting digital marketing efforts towards COVID testing. While this strategy resulted in short-term financial gain, UCs are now experiencing some negative long-term consequences.

As an alternative to the COVID-first strategy, some clinics chose to stay the course, maintaining their pre-pandemic models and merely adding COVID testing/treatment to their offerings. These clinics demonstrated resiliency and foresight by continuing typical treatment and supplementing as reliable testing sites, keeping in mind the pandemic and COVID testing would eventually wind down. Their commitment to maintaining a broader spectrum of urgent care services positioned them to thrive long-term, and they are better suited to manage new problems such as low visit volumes. Urgent cares that adopted this more conservative approach have been able to return to normalcy more smoothly and are primed to take advantage of their position by leading the effort to relieve crowded EDs.

Aspects of successful clinics: Strategies revealed

Among the thousands of UC clinics that operate throughout the U.S., the ones that have shown the most consistency in their operational and clinical success display similar characteristics and strategic approaches.

Augmenting fundamental services: A comprehensive approach

Leaders of successful clinics revealed a strategic departure from the COVID-first approach. Rather than replacing fundamental urgent care services with COVID testing, thriving clinics augmented these services, ensuring a seamless continuation of care. These clinics, even amid the high volume of COVID patients, sustained a full slate of urgent care services, including laceration treatment, fracture repair, non-surgical orthopedics, and other common urgent care circumstances. Notably, they prioritized maintaining radiology services, a key differentiator for thriving urgent care clinics.

Team approach to staffing: Strengthening the core

A crucial aspect of successful clinics lies in their adoption of a "team approach" to staffing. Cross-training staff to cover various roles and responsibilities became essential, with Advanced Practice Provider (APPs) empowered to handle front desk tasks and care providers taking on APP duties. This innovative approach not only stretched staff resources but also balanced workloads, supporting staff morale and patient care prioritization.

Patient loyalty and satisfaction: Nurturing relationships

Prosperous clinics prioritized retaining non-COVID patients. These clinics revitalized lagging visit volumes by unwaveringly offering traditional urgent care services and re-engaging patients needing radiology services. Especially as other UC clinics lessened their scope of services, they were able to attract new patients and continue to expand their businesses. By avoiding encouraging non-COVID patients to seek medical treatment elsewhere, these clinics fostered loyalty and satisfaction.

Billing optimization: Ensuring financial health

While many high-performing clinics had optimized billing processes in place before the pandemic, ensuring they were using all available resources and capabilities was paramount. Prioritizing resources to stay on top of patient and payer payments, including insurance eligibility verification and maintaining credit card information on file, played a crucial role in sustaining the financial health of these clinics.

Maintaining regular operating hours: Consistency amidst challenges

Despite widespread staff challenges during the pandemic, including illness, burnout, wage inflation, and hiring difficulties, prospering clinics maintained regular operating hours, including evenings and weekends. This commitment prevented patient migration to new providers, promoting consistency in COVID care and traditional urgent care services.

Diversified marketing strategies: Beyond digital dominance

On the marketing front, successful clinics did not solely rely on digital ads for COVID testing. Instead, they diversified their media mix, employing grassroots marketing initiatives in their communities, and used conventional advertising media despite higher costs. These campaigns targeted specific audiences which generated new partnerships with schools and local businesses, resulting in new patients. These clinics secured a strategic advantage by focusing on longer-term returns on investment and reaching outside the digital noise.

Focusing on the future

Ultimately, the success of urgent care clinics is determined by forward-thinking strategies and planning, in addition to the ability to adapt to the unknown. As profitability opens doors to opportunities, high-performing clinics should continue to seek ways to not only expand their businesses but make valuable contributions to the healthcare industry that promote positive systemic change. Growth strategies – including opening new clinics, relocating to larger spaces, and introducing new specialties such as pediatric urgent care – should be considered. As emergency overcrowding persists, urgent care clinics should adopt these tactics to not only alleviate the burden on emergency department staff, but to return to the strategy that made them successful two-decades ago: providing quality healthcare based on the demands of patients, flexibly adapting as these needs change, and supporting the communities that count on them with more convenience than any other sector of the healthcare ecosystem.