Urgent Care Boom Equates to Increase in Hospital’s Revenue per Admission

Urgent Care Boom Equates to Increase in Hospital’s Revenue per Admission

Over the course of the last decade, U.S. hospitals are continuing to expand their urgent care clinic networks. According to a NPR/Kaiser Health News report, the primary goals for adopting a more decentralized approach through urgent care facilities include:

• Expanding the footprint/brand of the health system (at a discounted rate)
• Generating new referrals
• Keeping patients out of the ED (40% of ED visits nationwide DO NOT require Emergency Services)
• Boosting patient satisfaction

Although urgent care clinics alone are rarely lucrative, their capacity to boost referrals and generate downstream urgent care revenue through follow-up care can make them financially valuable to hospitals and health systems, according to NPR/Kaiser Health News.

In 2012, hospitals owned about 27% of the nation’s 6,000+ urgent care clinics while the rest generally belong to corporations or physicians, according to the Urgent Care Association of America.  In 2017, Urgent Care Association of America reports hospitals own about 36% of the 7,600+ urgent cares operating through the United States.

But how has the decision to invest in urgent care affected the hospitals or health systems?

As highlighted in this Modern Healthcare study of the top US for-profit brands, efforts are paying off.

As a result, two factors largely drive the increases in revenue per admission, experts say: higher prices and sicker patients.

Insert into the mix, Health System owned urgent care facilities. As a direct result of offering more convenient, affordable services to their patient populations, hospitals and health systems can care for really sick patients. It makes sense that as patients increasingly migrate to lower-cost, more convenient outpatient settings, hospitals will see the most severe cases.

Hospital chains are actively adding high-acuity service lines in some markets to ensure they’ll get those sicker patients. Additionally, hospitals are beginning to utilize these settings to reach more rural markets where smaller community hospitals aren’t viable.

Recommendations for Next Steps

A potential pitfall that will occur as a result is increased pressure on quality physician documentation and coding services.  As hospitals see more severely ill patients, physician documentation and coding services related to it will face even more scrutiny.

YES HIM Consulting works side-by-side with healthcare entities that have identified and deal with this challenge on a daily basis. We provide a wide range of personalized services related to education, mentoring, coding and compliance auditing. YES HIM Consulting, Inc.’s Education and Coding Services can be found here.