9 Ancillary Services That Can Boost Practice Revenue

Leigh Page

Disclosures

August 07, 2014

In This Article

What Will It Cost?

Start-up costs for an urgent care center are at least $1 million per center and can go much higher. Pash advises leasing high-cost retail space and building it out, at an anticipated cost of $850,000 or more. You'll also need to buy new equipment, including an automatic electronic defibrillator, sterilizer, breathing machine, and microscope, at a total cost of about $75,000 new and $25,000 used, according to Clayton.

Clayton cautions against buying a lot of expensive equipment. For instance, there won't be enough patients with fractures to justify a radiography machine. "You need high volume to justify it," he said. "Three x-rays a day won't pay for it." Aburmishan, on the other hand, favors offering radiography and buying a less expensive portable unit. (For more details, see the section below on introducing radiography in your practice.)

Clayton suggests laying aside an advertising budget of $18,000-$38,000, because you'll need more patients than you'll get just by word of mouth. Insufficient volume, he said, has put many an urgent care clinic out of business. To be successful, he advises that a facility have 12,000-13,000 visits per year; whereas some urgent care clinics reach that level within just 6 months, it can take 2 years or more in some markets, he said.

Viewing the risk for failure, Clayton advises making a feasibility study before you make any moves. "You can't just go and declare you're in the urgent care business," he said. "You have to study demand." You need to be in a community of at least 40,000 people, and maybe even 100,000, he said. Then, you need answer some key questions, such as: How many urgent care clinics are there around already? How many patients cannot get an appointment at PCPs in the area?

Also, Pash advises contacting major insurers in the early planning stages to determine whether they will cover your patients. It can take months to negotiate coverage with insurers. Patients who don't have coverage will have to pay entirely out of pocket, which will quickly drive them away, she said. Clayton adds that patients should be told that insurers often charge higher copays for urgent care than for visits to a practice.

Tinsley, the Houston consultant, said he doubts that many physicians would be interested in taking on all the responsibilities of an urgent care center. He noted that an urgent care facility requires separate credentialing, a different ID number, and a different payment system with a global fee. Instead, he thinks practices should offer extended hours to capture the young, healthy patients who use urgent care centers. "You could be open every other Saturday," he suggested.

Urgent Care Center Scorecard

Start-up costs: At least $1 million, but you can start at minimal expense by extending hours within your own practice.

Potential income: $2.1 million a year for a full-fledged operation.

Pros: For the most part, these are services that PCPs are already providing.

Cons: Setting up a separate urgent care clinic is very expensive and time-consuming, and it may require significant changes in physicians' schedules.

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