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Urgent Care Boom Equates to Increase in Hospitals Revenue per Admission

Urgent Care Boom Equates to Increase in Hospitals 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 from December 2017, 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 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, just five years later, the Urgent Care Association of America numbers report hospitals own about 36% of the 7600+ 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 examining some of the top for-profit brands across the nation, efforts appear to be paying off.

Increases in revenue per admission are driven largely by two factors, 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 patent populations, hospitals and health systems can begin to focus on what they were designed to do: care for SICK (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 working to capitalize on that by adding high-acuity service lines in some markets to ensure they’ll rope in those sicker patients. Hospitals are also beginning to utilize Urgent Care settings to reach more rural markets where smaller community hospitals aren’t viable.

A potential pitfall that we at YES HIM Consulting, Inc. believe will occur as a result of hospitals increased acuity is an increase in pressure on quality physician documentation and coding services.  As hospitals continue to see more and more severely ill patients, physician documentation and the coding services related to it will face even more scrutiny than in the past. 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 service lines related to Education and Coding Services can be found here.

JJ Crumbley

JJ Crumbley, MBA, PMP – Director Project Management & Operations

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