Journal of Urgent Care Medicine

Urgent Care Refers 1 Patient in 50 to the ED

Urgent Message: Urgent care sends roughly 1 patient in 50 to the emergency department. Most of those referrals involve symptoms that call for imaging, laboratory testing, or monitoring that the clinic cannot provide. Some are emergencies identified during the visit for an ordinary complaint. Keywords: emergency department referral; emergency department transfer; urgent care referral patterns; practice variation; clinical documentation; urgent care operations Alan A. Ayers, MBA, MAcc Consider a scenario in which a patient writes …

Size and Ownership of U.S. Urgent Care Centers, 2026

As of July 1, 2026, there were 14,495 urgent care centers in the United States, according to National Urgent Care Realty data. The charts above break down that footprint by the number of locations per operator, affiliation with a hospital or health system, private equity investment, and participation in a health system/private equity joint venture. From the data: 56% of urgent care centers are operated by groups of 10 or more locations, up from 54% …

How Often Do Urgent Cares Close Unexpectedly?

The average urgent care center goes unexpectedly “dark” 2.3 days a year—which means it closed on a day it otherwise should have been open (eg, staff illness, building repair, power outage, etc.). And the range of unexpected closure days is wide. Centers run by operators that have only a single location experience unexpected closures 4.6 days a year. Centers with 76 or more locations have 1.7 days of unexpected closures per center per year. The …

Urgent Care Practice Varies More by Provider on Duty Than by Center, Payer, or Patient

Urgent Message: Urgent care operators may find practice variation in testing, imaging, referral, and coding among clinicians working in the same clinic. According to this data analysis, the reason for variation ultimately comes down to the decision making of the individual clinician rather than infrastructure, payer, or patient population. Alan A. Ayers, MBA, MAcc Keywords: urgent care practice variation; provider variation; clinical practice patterns; diagnostic testing; referral patterns; evaluation and management coding; clinician performance Walk …

Mandated Paid Sick Leave, FMLA, and the Complex Landscape of Absence Management

Urgent Message: To protect clinic continuity and avoid financial liabilities, urgent care operators must master the complex, overlapping patchwork of federal and state employee-leave laws to navigate paid-time-off traps, callouts, and defensible terminations. Alan A. Ayers, MBA, MAcc Keywords: Family and Medical Leave Act; paid sick leave; paid time off; employee absence management; Americans with Disabilities Act; attendance policy The regulatory environment governing employee absence in the United States is a complex, overlapping patchwork of …

Retail Clinics Shrink By 33%

RETAIL CLINIC ROOFTOPS BY HOST Between May 2023 and June 2026, the number of health clinics hosted in retail settings in the United States fell from 1,750 to 1,166. This represents a 33% overall decline from the 2023 peak. The decline also includes a recent 15% drop since our previous analysis, which found 1,370 sites in operation from May 2023 through December 2024.1 The contraction began when CVS, Walgreens, and Walmart announced closures and has …

The Anatomy of a 1-Star vs 5-Star Google Review

While many urgent care operators measure their overall Google ratings—focusing staff on capturing as many “5-stars” as possible—few understand the specific staff behaviors and patient experience that drive positive and negative reviews. To identify the differences, Urgent Care Consultants analyzed the content of 3.1 million Google reviews across 3,665 urgent care centers. The table breaks down the specific themes driving positive and negative experiences. A positive gap indicates a theme more prevalent in 5-star reviews, …

Quantifying the Front Door: A Blueprint for Tracking Urgent Care Downstream Referrals and ROI

Urgent Message: Health systems must reframe urgent care from a low-margin cost center to a strategic front door that drives significant returns by utilizing technology to track and maximize “keepage”—the retention of high-value downstream referrals that otherwise leak out of the network. Alan A. Ayers, MBA, MAcc Keywords: urgent care; referral management; downstream revenue; health system strategy; patient retention; return on investment Urgent care is no longer just an access point; it is the strategic …

The Structural Divide in Urgent Care Occupational Medicine

Data reveals that occupational medicine in urgent care is fundamentally top-heavy. As the table illustrates, the top 20% of clinics drive 29% of their total occupational medicine visit volume through employer-paid services (EPS) and workers’ compensation (WC) -paid services, averaging 12 daily visits. Conversely, the bottom 20% average less than 1 visit per day from these 2 payer types. Private-insurer or patient-paid services account for the balance of the visits overall. This stark disparity is …

Who Can Take X-Rays in an Urgent Care Center: A 50-State Framework

Urgent Message: This 50-state framework details who can legally operate x-ray equipment, as these laws dictate whether the industry’s predominant advanced practice provider-staffing model remains operationally and financially viable. Alan A. Ayers, MBA, MAcc Keywords: urgent care; radiography; radiologic technologists; licensure; nurse practitioners; physician assistants According to the Urgent Care Association (UCA), on-site plain-film radiography is a defining feature of urgent care and is among the criteria for UCA Certification.¹ Yet across the 50 states …

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