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On-Demand Healthcare – Integrating Primary Care While Staying True to the Urgent Care Mission

Not everyone who visits an urgent care will seek primary care services, but the ability for clinics to provide PCP services on an as-needed basis is a massive value-add for all stakeholders - be it providers seeking to bolster their financial positions or patients who are suffering from provider shortages in primary care.

Urgent cares are known for their accessibility and efficiency, often relied upon by patients in lieu of traditional primary care providers (PCPs) who are few and far between in so many areas.

Primary care physician availability and access challenges persist among industry-wide labor shortages and with residents flocking to higher-paying specialties. Though not their traditional area of expertise, there is a unique opportunity for urgent cares to step into the primary care market — supplementing the need for this kind of care, rather than taking away business from standalone PCPs or those in networks.

Primary care differs from urgent care with its simplicity, focusing on the big picture for the patient, whereas urgent care more often involves x-rays, labs, and machines. Together, the two can extend the reach of both services for patients that otherwise would not be receiving either. Bringing primary care into an urgent care setting – without sacrificing the efficiency and accessibility for which on-demand care is so highly valued — can drive better outcomes and benefit care providers, clinic owners/staff, and most importantly, the patients.

Integrating primary care into clinic operations  

The way healthcare providers operate on a daily basis, from scheduling appointments and seeing patients to completing charting and paperwork, is unavoidably affected by organizational changes. Adding primary care to a clinic’s services will inevitably interrupt workflows, but it’s a change well worth the initial disruption – and luckily, the integration of primary care involves far fewer hurdles than many other new services. In a sense, it’s a natural extension of the services already provided at urgent care centers.

When realistically gauging whether your urgent care clinic will be successful in this integration, consider the willingness of staff to adapt, as well as the clinic’s visit volumes and capacity. During peak flu season, when clinics experience their highest visit volumes and bandwidth is limited, taking on a new set of services may not be as successful for clinics, and will likely be met with resistance from staff. In the summer months, though, a visit volume gap is revealed, and adding primary care appointments could actually help maintain a steady pace for overall clinical operations.

If a clinic is experiencing higher-than-average visit volumes year round and still looking to offer primary care services, they could opt to hire a separate dedicated in-house PCP to solely serve those patients, rather than modifying current urgent care staff allocations. Adding services is no small task for any type of practice, but urgent cares are uniquely positioned to aid in the primary delivery care given the range of services they already provide.

Addressing patients’ needs

Urgent care is known to be the de-facto medical walk-in provider for patients. Nearly one-third of Americans lack access to primary care, so there is an untapped market within the urgent care patient population for individuals that do not have an established PCP.  During a visit to an urgent care site that offers primary care, patients can have their urgent care needs addressed, such as a sprain – and the visit can be supplemented with a primary care check-in that upholds the accessibility and efficiency of urgent care. By taking a step further to do a full physical exam, the provider can help identify underlying conditions that may otherwise have gone untreated. A more well-rounded suite of services drives better patient outcomes, helps meet the growing demand for quality care, and reduces the likelihood of future visits (and the accompanying financial burden) by addressing concerns before they turn into bigger health problems.

Rather than waiting for specialty care and referral visit scheduling, more of a patient’s care needs can be addressed in a single visit with this full service model, further elevating urgent care’s reputation for efficiency. With a growing aging population and a shortage of primary care practitioners, urgent cares are able to step in and make sure patients are still receiving the care they need.

The business of care

The benefits of adding primary care to the suite of services offered by urgent care clinics go beyond the clinical and operational. New services bolster these businesses financially — by reaching more patients, driving return visits, and increasing profit margins. In the current economic state, overhead continues to rise, including rent, pay, and fees-for-service, so urgent care clinic owners must find ways to keep visit volumes up while still offering quality and efficient care. The addition of primary care offerings can not only help urgent care clinics break even during uncertain times, but also increase revenue down the line (as opposed to bringing on a new testing service, for example, where the breakeven line is simply raised with no profit increase).

Offering primary care appointments can not only increase the number of visits a clinic sees, but the revenue that each of those visits generates. This can improve urgent care’s expertise and reputation in chronic condition care. Medicare, especially, supports facilities taking on patients with chronic conditions, such as diabetes and hypertension, because of their recurring nature. Recurring visits are key in setting clinics up for future success with ongoing streams of revenue.

Not everyone who visits an urgent care will seek primary care services, but the ability for clinics to provide PCP services on an as-needed basis is a massive value-add for all stakeholders. Though the initial implementation of such an extensive new service can be a burden, it will generate consistent revenue for a clinic, improve the patient experience, and most importantly, provide a new point of care delivery for a service that is severely needed.

Photo: alphaspirit, Getty Images


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Alan A. Ayers

Alan A Ayers, MBA, MAcc, is president of Experity Consulting, responsible for helping clients identify and cultivate new revenue streams while supporting the company's strategic growth initiatives. Ayers is also a prolific and award-winning writer serving as Senior Editor of The Journal of Urgent Care Medicine (JUCM), and has contributed well over 650 original articles, blog entries and presentations on urgent care-related subjects.

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