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Urgent Care Clinics in 2019: Industry Trends & Market Stats

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What are urgent care clinics?

Urgent care centers are convenient, on-demand care outlets similar to walk-in retail clinics, but rather than treating low-acuity conditions such as bronchitis and minor infections, urgent care clinics are equipped to treat more serious ailments, including fractures, sprains, and wounds. They also offer services like blood tests, stitching, and X-rays.

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Urgent care centers can serve as a first step in the patient journey as well by referring patients to follow-up appointments or ERs. Though they should not be used for life-threatening emergencies, urgent care clinics provide easy access to quality healthcare for times when your primary care doctor is unavailable.

The urgent care market & business model

According to Consumer Reports, the number of urgent care facilities increased from 6,400 in 2014 to 8,100 in 2018, with another 500 to 600 expected to open. Some 24/7 urgent care centers function like satellite emergency rooms, and incur similar costs, while other centers simply charge copays.

John Normile/Getty Images

Generally speaking, an urgent care visit is a money-saver for patients. A 2016 study in the Annals of Emergency Medicine found that ER treatment costs were about 10 times more (an average of about $2,200) than in an urgent care center (about $168) — even for patients with the same diagnosis.

Because of the overlap urgent care centers have with family medicine and emergency medicine, they are typically staffed accordingly with at least one medical physician or specialist, as well as a physician assistant, nurse practitioner, or radiologist available to see patients any time the facility is open.

Urgent care staffing models

Henry Schein Medical cites three major urgent care center staffing models:

  • Physician Only: The most expensive model that uses no mid-level practitioners. However, it could be the most cost effective options for new centers building their patient base.
  • Mixed Model: A balance of physicians, physician assistants, and nurse practitioners for centers increasing in patient volume.
  • Mid-Level Model: Centers staffed entirely by mid-level staff. This option is suitable for low acuity cases, but may not be equipped to handle more complex patient needs.

Top urgent care providers

Urgent care clinics aren’t necessarily run by traditional hospitals or health systems. In fact, 61% of urgent care clinics in Massachusetts are owned by non-hospital chains, per a 2018 Massachusetts Health Policy Commission report.

Some of the largest US urgent care providers include:

  • American Family Care
  • City MD
  • Concentra
  • Fast Med
  • GoHealth
  • HCA CareNow
  • MedPost
  • NextCare
  • Patient First
  • U.S. Healthworks

Urgent care industry trends & statistics in 2019

Interest in the on-demand, affordable care of urgent care clinics has been growing rapidly. According to the Urgent Care Association (UCA), the total number of urgent care centers in the U.S. reached 8,774 in November 2018 — up eight percent from 8,125 in 2017.

St. Louis Urgent Cares
Apple

Laurel Stoimenoff, PT, CHC, CEO of UCA, says that urgent care clinics handle about 89 million patient visits each year, which includes more than 29% of all primary care visits in the US, and nearly 15% of all outpatient physician visits.

And nearly all of those visits are more convenient and affordable than a trip to the ER; the UCA’s 2018 Benchmarking Report found that more than 70% of patients waited less than 20 minutes to see a provider at an urgent care center, and nearly 94% were seen in less than 30 minutes. Overall, 85% of urgent care centers patients are taken care of in under an hour.

“Urgent care centers play an increasingly vital role in the continuum of care, providing services for a wide array of patients who may be unable to see a primary care physician for various reasons, including simply not yet affiliating with one,” said Stoimenoff.

This is especially true of millennials, who are leading the way in driving demand and increased utilization of urgent care centers; Business Insider Intelligence research shows that nearly half of millennials (45%) do not have a primary care physician — largely due to providers’ failure to create a consumer-oriented healthcare experience.

And as Baby Boomers continue aging into Medicare, the number of Medicare and Medicaid patients seeking services at urgent care centers continues to grow, accounting for nearly 27% of all visits in 2018.

More to Learn

Business Insider Intelligence has been following the transforming landscape of digital health, including how the explosive growth of urgent care clinics is shaking up the traditional healthcare landscape — and what it means for payers, providers, manufacturers, and medical supplies distributors.

Our first Digital Health Ecosystem Report explores the current healthcare ecosystem, the key trends driving digital transformation, and where the industry is headed. It discusses the most transformative digital health technologies and outlines the investment areas gaining the most funding to help illuminate the future path of digital healthcare.

Want to learn more about the fast-moving world of digital health? Here are three ways to get access:

  1. Purchase & download the full report from our research store. >> Purchase & Download Now
  2. Sign up for Digital HealthPro, Business Insider Intelligence’s expert product suite keeping you up-to-date on the people, technologies, trends, and companies shaping the future of healthcare, delivered to your inbox 6x a week. >> Get Started
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The choice is yours. But however you decide to acquire this report, you’ve given yourself a powerful advantage in your understanding of the fast-moving world of Digital Health.



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Amazon needs to stay ahead of competition from Microsoft, analysts say

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  • Analysts say that Amazon Web Services’ conference AWS re:Invent shows that the cloud giant is more reactive than ever to competition from Microsoft and Google Cloud.
  • Although AWS is still well ahead of its competition, analysts say that Microsoft is putting on an “aggressive front” when it comes to partnerships.
  • While Amazon wants users to go all-in with its cloud, customers and partners alike may be wary of investing too deeply in AWS — after all, they could be competitors tomorrow.
  • One of the biggest announcements was AWS Outposts, a hybrid cloud product that allows customers to run their applications on both AWS and their private data centers using Amazon hardware. Outposts opens up a big new opportunity for Amazon.
  • Click here to read more BI Prime stories.

Amazon Web Services is still the biggest cloud around, and isn’t shy about making sure that its customers know it.

Still, experts say, Amazon is showing more signs than ever that it’s paying attention to the mounting threat posed by competitors like Microsoft or Google Cloud — despite repeated claims from AWS over the years that it pays more attention to its customers than to what the rest of the market is doing.

“I think that even though Amazon claims they’re driven by customer needs and not competition, I found they reacted more to competition this time than I’ve seen in the past,” Sanjeev Mohan, senior director analyst at Gartner, told Business Insider. 

At AWS re:Invent, Amazon’s biggest cloud conference held in Las Vegas last week, the cloud giant made several announcements in artificial intelligence, quantum computing, and other cutting-edge fields.

More than anything, though, AWS wanted attendees to come away with one message: “We’re better, we release things faster and have more customers,” says Ray Wang, principal analyst and founder of Constellation Research.

Indeed, according to Gartner, Amazon Web Services currently has 47.8% market share in the public cloud market. By comparison, Microsoft has 15.5%, Chinese cloud giant Alibaba has 7.7%, and Google has 4%. All of those companies allow customers to rent functionally unlimited computing power from their own hyperefficient data centers.

Despite Amazon’s dominance, however, those competitors have found ways to grow. Ray Wang, principal analyst with Constellation Research, says that Google has built a reputation as leading in artificial intelligence and machine learning, while Microsoft’s experience with enterprises gives it a strategic edge. 

“They’re building new industries along the way, and customers are still innovating with them,” Wang said. “The market is changing. Microsoft Azure is gaining market share and mindshare as well but it’s because there are a lot of pre-existing contracts. Google was seen as the place to go for AI and ML, but what Amazon has tried to do was narrow the perception.”

Through that lens, Amazon’s re:Invent announcements can be seen as a maneuver to show that it’s meeting or beating the expectations set by its leading rivals.

Microsoft’s ‘aggressive front’

AWS is still the top cloud in the market, but it needs to watch its back, analysts say. In particular, AWS will need to watch out for Microsoft, experts agree — especially in the wake of Microsoft’s surprise win of the $10 billion JEDI contract, a deal with the Pentagon to modernize its IT infrastructure by way of the cloud.

“The elephant in the room during much of re:Invent was Microsoft, which has made impressive strides in cementing itself as the No. 2 cloud provider and threw AWS (and the rest of the industry) for a loop with the JEDI win,” William Blair analyst Jason Ader wrote in a note.

Microsoft has been bolstering its growth by presenting an “aggressive front” when it comes to partnerships and acquisitions, Gartner vice president Sid Nag said, striking big deals in order to stay competitive with AWS. 

“I don’t think they’ll do major shifts in strategy but they need to make sure they stay ahead of the game,” Nag told Business Insider. “Microsoft’s strategy has been all about growing their business inorganically to compete with AWS. AWS has to keep up with that. Definitely this will help AWS keep that momentum going. Clearly they’re not slowing down.”

AWS is currently challenging Microsoft’s win by way of a lawsuit, even as AWS CEO Andy Jassy has already started to strike a “combative tone” when it comes to Microsoft, as Ader wrote. At re:Invent, Jassy criticized Microsoft’s price increases and highlighted the fact that customers use AWS to run Windows in the cloud. 

Going all-in

Another takeaway from re:Invent, experts say, is that AWS hopes to give customers an incentive to go all-in on its cloud.

Although AWS is announcing a host of new features to make it more rounded-out as a platform, Wang says customers will still look to use multiple clouds – something that AWS historically hasn’t encouraged. Complicating the issue is that some customers might be wary of turning to AWS, when they might compete with its retail or other businesses at the same time.

That dynamic has also come to the software industry itself. In a report after the event, Ader wrote that AWS’s goal to become a “one-stop shop” has “ruffled more than a few feathers,” as partners like MongoDB, Redis Labs, and DataStax both work with and directly compete with AWS. 

Some of these vendors have even gotten closer to Microsoft and Google because they’re seen as more partner-friendly, Ader wrote.

This all adds up to an environment where customers and partners are both worried about investing too deeply in AWS, at the expense of their freedom to try to the others.

“That’s really going to be the nature of what’s happening,” Wang said. “Every cloud vendor we talked to was scared of cloud lock-in. They are so scared they will make those same mistakes.”

AWS Outposts

One of the biggest new products announced at the event was AWS Outposts, which AWS announced last year and launched into general availability this year. It’s a hybrid cloud product, which allows customers to run their applications across both the cloud and in their private data centers using AWS hardware. That’s a big shift for Amazon, which for a long time discouraged that kind of hybrid scenario.

“AWS has always been a public cloud provider,” Nag said. “They didn’t really have a strong hybrid story. For the foreseeable future, hybrid is going to be the most relevant model for cloud. They’ve been lacking on that front.”

Hybrid cloud is something that customers have been asking for, as many choose to keep using private data centers for reasons that might include regulatory compliance. That means that Outposts represents a possibly huge new opportunity for Amazon.

“Outposts is huge,” Wang said. “Part of the reason why that’s so important is because customers want hybrid. That was one of the big items. It was good to see they talked about it and good to see them delivering on it.”

Microsoft has long had its own hybrid cloud product on the market. Still, analysts say there is still space for both cloud giants.

“Ultimately, given the still-early stage of cloud adoption, we believe there is plenty of room for both AWS and Microsoft to be successful, and we expect them to be the top two cloud providers for many years to come,” Ader wrote.

Got a tip? Contact this reporter via email at rmchan@businessinsider.com, Signal at 646.376.6106, Telegram at @rosaliechan, or Twitter DM at @rosaliechan17. (PR pitches by email only, please.) Other types of secure messaging available upon request. You can also contact Business Insider securely via SecureDrop.



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Saudis at US bases on ‘safety stand-down’ after NAS Pensacola shooting

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  • Roughly 300 Saudi military aviation students at Naval Air Stations Pensacola, Whiting Field, and Mayport have been grounded for a safety stand-down and operational pause in the wake of last week’s shooting in Pensacola, Reuters reports.
  • The stand-down is a non-punitive effort to prepare Saudi students, which the Navy characterized as the “most impacted” by the traumatic attack, to resume their aviation training.
  • It is unclear when the safety stand-down and operational pause will conclude as there is currently no set end date, the Navy told Insider.

Around 300 Saudi military aviation students have been grounded as part of an ongoing safety stand-down and operational pause, Reuters first reported.

Mohammed Saeed Alshamrani, a Saudi military officer in the US for training, opened fire on students and law enforcement officials at Naval Air Station Pensacola last Friday, killing three US Navy sailors and injuring several more people.

The safety stand-down began Monday, the service told Insider, explaining that this was a non-punitive procedure intended to help Saudi students, whom the Navy characterized as “the most impacted” by last week’s traumatic shooting.

The aim of the stand-down is to help these students prepare to restart training at a yet-to-be-determined later date.

The pause is taking place at NAS Pensacola, NAS Whiting Field, and NAS Mayport, all of which are US Navy bases in Florida, Reuters reports.

Classroom training for Saudi students is expected to begin soon, but it remains unclear when these students will be able to resume flying. Training, including flight training, has already resumed for US military personnel, as well as other international military students at the bases.

There are roughly 850 Saudi military personnel in the US for training, according to Reuters.

Sen. Rick Scott, a Florida Republican, has been calling for “a full suspension of the program until a thorough review by both the Department of State and the Department of Defense are completed,” his office told Insider in a statement.

There is currently no indication that the military has plans to suspend its training of foreign military personnel. 



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Man received testicle from his twin brother in rare transplant

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  • On December 3, a 36-year-old man in Serbia became the third known person to receive a testicle transplant.
  • When a man’s testicles are nonexistent, he experiences both reproductive- and hormone-related problems, Dr. Bobby Najari, the director of the Male Fertility Program at NYU Langone Health, told Insider.
  • But testicle transplants are rare because donating a testicle requires the donor to contribute his sperm to the recipient as well, and there are other ways testosterone can be replaced.
  • Still, the procedure may have positive implications for transgender people, wounded soldiers, and cancer survivors.
  • Visit Insider’s homepage for more.

On Tuesday, December 3, a 36-year-old man became the third known person to receive a testicle transplant.

The man, who underwent the transplant in Belgrade, Serbia, wasn’t born with any testicles and got one testicle from his identical twin brother, the New York Times reported.

The two previous testicle transplants were performed nearly 40 years ago, and both also involved identical twins. 

Being born without testicles is rare. According to the National Institutes of Health, only 0.15% of full-term male babies are born without testicles. (It’s more common — about 3% of full-term male babies — to be born with undescended testicles, but in most of those cases, the testicles drop to the correct position before they’re 6 months old.)   

When a man’s testicles are nonexistant, he experiences both reproductive- and hormone-related problems, Dr. Bobby Najari, the director of the Male Fertility Program at NYU Langone Health who was not involved in the transplant, told Insider.

Although the hormone-related problems can be fixed with hormone replacement therapies, only a testicle transplant can potentially help a man born without testicles gain reproductive abilities.

Testicles have both hormonal and reproductive functions

The testicles serve two purposes. First, they release the hormone testosterone, which is responsible for a man’s muscle growth, facial hair growth, and sex drive, according to the Urology Care Foundation. But if a man doesn’t have testicles, he won’t release testosterone and needs to get the hormone through a replacement method, Najari said.

Replacement methods include injections administered by the man himself or his doctor, oral medications, or topical medications.

The testicles also play a primary role in reproduction, since they contain the sperm needed to fertilize an egg, which develops into an embryo and then a fetus. Without testes, a man can’t have genetic children of his own.

Even with a testicle transplant, a man who previously had no testes isn’t guaranteed to have kids, Najari said. That’s because it would require an extra surgical step during which a surgeon attaches the vas deferens — the male reproductive organ that connects the sperm to the urethra at the tip of the penis — to the recipient’s own penis.

If the vas deferens isn’t connected to the recipient’s penis (it wasn’t this new transplant case), then the sperm have no way of leaving the scrotum, entering the penis, and exiting the penis in the form of ejaculate, according to Najari.

If the vas deferens are attached, it adds about an hour to the procedure, which is already about three hours long, Najari said.

organ donor surgery cancer

The testicles play a primary role in reproduction.
nimon/Shutterstock


Testicle transplants are rarely performed

Testicle transplants require surgeons be extremely physically adept because they must fuse the donated testicle’s blood vessels with the recipient’s blood vessels in order for the donated testicle to function properly, according to Najari.

But the difficulty of the procedure itself isn’t why testicle transplants are rare, Najari said. Rather, it’s because “you’re transplanting the donor’s sperm into the recipient, so the recipient’s children are going to be the testicular donor’s children, from a genetic standpoint.”

It’s not common for people to want to donate their sperm to a stranger in this capacity, or for a deceased organ donor to consent to this while alive, which explains why the three transplants completed thus far have been with identical twins.

Testicle transplants could be revolutionary for transgender people, wounded soldiers, and cancer survivors

Although testicle transplants are rare, the procedure has the potential to change the lives of people in need of a testicle, Najari said.

Transgender men who aren’t born with male reproductive organs, for example, could have more reproductive options if they received a testicle transplant.

Additionally, wounded soldiers and cancer survivors who lost their testes could benefit from the procedure if they don’t wish to use other testosterone-providing methods or want to have children.



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