Gregory Kolovich MD MPH – Optim Orthopedics – Savannah, GA
It’s 6 p.m. on a Saturday, and 3 people — a trauma patient with a severe musculoskeletal injury, a high school athlete with a bad ankle sprain and a weekend warrior with a fractured wrist — hobble into a hospital’s ER. Hours pass as they wait to be seen by a physician, who may or may not be an orthopedic specialist, and healthcare costs pile up along the way.
There’s a better option.
Nearly 2 years have passed since we first opened the doors to our orthopedic urgent care center, where our team of 20 orthopedic specialists sees walk-ins, even during off-hours and on weekends, for everything from sprains and fractures to severe trauma.
From our experience, the model can decrease costs, speed up treatment times and, in turn, expedite a patient’s recovery. That may explain why we’ve seen so many other urgent care centers popping up across the country. Even with the increase in competition, we remain bullish on urgent care, both as a matter of patient convenience and as a business opportunity.
Urgent care has been red hot for several years, with newly built centers now vying for prime real estate. The American Academy of Urgent Care Medicine’s most recent count puts the number of U.S. urgent care centers at 9,300 — up from 8,000 since 2008 — though others say it’s closer to 12,000 and growing at a clip of 600 per year. Many of these locations are either franchised or affiliated with hospitals as catchall extensions of the ER, but an increasing number of surgical practices like ours have found value in adding orthopedic-specific urgent care centers to the fold.
When we opened our urgent care center, we saw it as a way to offer convenient care to patients. At the same time, the model can be quite lucrative, as it acts as an ongoing source of revenue for surgical referrals and follow-up care. If a patient comes in with a fractured wrist, you stabilize them, treat their pain, and triage them to an orthopedic specialist who can provide them with the appropriate care. —The clinic can therefore be an in-house source of surgical referrals. Considering the profit potential, it’s easy to see why orthopedic urgent care has become so popular, but running one successfully requires a lot of planning and introspection. My suggestions:
• Have a plan. First, examine your target market closely, as some markets might not welcome the addition of an urgent care center due to either oversaturation or unique market dynamics. Also, start the contracting process with payers as much as 6 months before the planned opening. You’ll find that payers are increasingly requiring certification and/or accreditation as part of their contracting process.
Consultants who specialize in this area can lead you through everything from navigating the regulatory rules to billing in order to maximize collections. Also, some urgent care franchisors offer turnkey marketing and operational guidance, but if you go that route, expect to spend several hundred thousand dollars on franchise fees and other related costs.
• Secure funding and staffing. The Urgent Care Association of America recommends earmarking about $800,000 if you’re building an urgent care from scratch. This should account for startup costs, as well as 3 months of operating expenses until you start receiving reimbursements from payers.
For staffing, you’ll need experienced physician assistants, supervised by a team of orthopedic surgeons. The PAs will likely see and treat all nonsurgical patients, supported by a team of medical assistants, cast technicians and X-ray technicians, as well as front-desk personnel. The square footage adds up, too. Figure on a footprint of 2,300 to 3,000 square feet, with dedicated space for exam rooms, casting and on-site imaging (X-rays and MRIs).
• Develop a marketing strategy. Considering the surplus of urgent care facilities, what would make yours different? Being an ortho-only urgent care center might allow you to pull musculoskeletal cases away from some all-encompassing urgent care centers, and if you have the support of or an affiliation with an established provider network, leverage it.
Our practice has been a recognized brand throughout Georgia for generations. We’ve built upon that reputation by sponsoring local sports teams, so our logo is everywhere. If a 5-year-old falls and sprains his wrist while he’s out on the soccer field, our logo is right there on his jersey, so his parents know exactly where to take him.
Read the original article published in Outpatient Magazine in June 2017