Journal of Urgent Care Medicine

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 …

The 2026 Urgent Care Top 100 By Number of Locations

Alan Ayers, MBA, MAcc Keywords: urgent care; ambulatory care facilities; joint venture; organizational affiliation The nation’s total urgent care center count reached 14,655 as of April 1, 2026, based on data provided by National Urgent Care Realty and Urgent Care Consultants. Of these, 6,056 locations (41.3%) are operated by a Top 100 entity. Hospital affiliations within the Top 100 remain the dominant model, with 55.9% of Top 100 locations participating in a health system relationship. …

How Off-Duty Statements Create On-Duty Liability

Urgent Message: There is effectively no right to “free speech” in a private employer-employee relationship. That means private healthcare employers have the authority to terminate staff whose off-duty statements violate professional ethics or harm the organization’s reputation. Alan A. Ayers, MBA, MAcc Keywords: free speech; social media; healthcare liability; malpractice risk; first amendment; employment law; ethical standards; risk management In today’s polarized political climate, the line between private citizen and public professional hasn’t vanished, but …

Which Generation Uses Urgent Care The Most?

Understanding generational demographics is critical for any organization because age drives consumer behavior.¹ While the U.S. population is distributed relatively evenly across adult cohorts,² urgent care utilization—based on an analysis of 2025 Experity EMR visit data conducted by Urgent Care Consultants—skews heavily toward younger adults.³ Gen Z and Millennials combined (born 1981–2012) account for more than 51% of all urgent care visits despite representing only 43% of the U.S. population—a combined over-index of nearly 20 …

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