Alan A. Ayers, MBA, MAcc, is Practice Management Editor for JUCM—The Journal of Urgent Care Medicine, a Board Director for the Urgent Care Association of America, and Vice President of Strategic Initiatives with Practice Velocity.

Urgent message: Many urgent care centers have embraced school, sports, and camp physicals as a way to raise awareness of their services among athletic directors, coaches, trainers, and parents of high school and middle school students. Because of the increasing attention given to the potential for traumatic brain injury in school sports, one urgent care provider has differentiated its sports participation physicals by focusing on concussion testing and prevention.

Concussion Prevention and Assessment
With tens of millions of U.S. middle school and high school students returning to school in August and September, many urgent care centers are now embarking on their annual sports physical campaigns. Assisting young athletes in gaining medical clearance and completing their mandatory participation paperwork provides an opportunity for students and parents alike to become familiar with an urgent care center’s facility, health-care providers, and staff members. This orientation often leads to visits to the urgent care center later in the school year when injury or illness is bound to strike. In April 2014, JUCM outlined this grassroots marketing tactic in “Marketing Strategies: School, Sports, and Camp Physicals.” One urgent care provider, Righttime Medical Care, with 13 locations in suburban Maryland, has differentiated itself from local competitors by expanding on the basic participation physical by emphasizing the risk of concussions in organized sports.

Concussions have drawn increased attention from athletic organizations, academic researchers, and media reports because of their detrimental long-term effects on cognitive function. Concussion prevention has thus become a major concern in all sports participants, from small children to professionals. Thus, Righttime has collaborated with HeadFirst to provide in each of its urgent care locations a community concussion clinic for the diagnosis, management, and treatment of traumatic brain injuries caused by a bump, blow, or jolt to the head.

Traditionally, patients with a concussion present to an emergency department (ED) because an immediate evaluation is necessary to determine whether a concussion has occurred and to protect the patient from further brain injury. ED visits of all kinds can be very expensive, and Righttime offers a much more cost-effective treatment option capable of handling most concussion cases without the overhead charges that an ED will include in its billings.
Righttime’s scope of services include the following:

  • Baseline testing: When diagnosing a concussion, a medical professional will compare an athlete’s test results to a normal baseline. It is best to compare that patient’s own baseline results to their post-injury results to evaluate whether a concussion has occurred. Righttime offers athletes the opportunity to come into a clinic and take a baseline test so that their results are available should they ever need to be evaluated for a concussion in the future (Figure 1). Not only does Righttime keep the results on file, but it also grants patients access to their results via an online portal, should they need to provide the results to their primary care provider. Baseline testing takes about 30 minutes, and Righttime charges a $20 administrative fee.
  • ConcussionCare_Figure2Post-injury testing: After a patient arrives with a suspected concussion, they are given a test identical to the baseline examination. Medical professionals then assess whether the results differ from the baseline findings. If baseline details are unavailable, the practitioners assess whether the current results differ from normative data for the patient’s age group (Figure 2). If it is determined that the patient has sustained a concussion, the patient enters the next phase of Righttime’s concussion service: follow-up care and return-to-play and return-to-school plans.
  • Follow-up care and return to play: If a concussion is diagnosed, Righttime will schedule that patient for multiple follow-up visits to monitor their recovery, preventing further injury to their brain. Righttime provides each patient with individual discharge plans and instructions to safely return to physical activity and to continue monitoring themselves for symptoms.
  • Billing: Sports participation physicals are a cash-only service. Righttime charges $45, with a $25 discount for patients who present during nonpeak weekday hours. There is an additional $20 charge for the baseline concussion test. Should a patient return with a suspected concussion, Righttime will bill the patient’s insurance for follow-up testing and medical treatment of the injury.

Righttime promotes these services through traditional and grassroots marketing tactics. Like many urgent care centers, they advertise in local newspapers. However, they also engage in community outreach efforts that not only raise awareness of the risks posed by concussions but also expose the public to Righttime’s expertise and services. On the Righttime website, a school or team can request a HeadFirst clinician to speak to their organization about concussions and their treatment. HeadFirst also provides information on concussion news and events on its website, including times and locations for their new brain-injury support group. These novel promotional approaches expose the community to the services that Righttime and HeadFirst offer, but more importantly, they benefit the public through increased health awareness. This approach to advertising is certainly a win-win for Righttime and HeadFirst and the community.

Concussion Care Benefits Righttime and the Community
On top of the benefits that the community and Righttime gain from these promotional strategies, there are additional benefits for both:

  • The community gets a much more cost-effective option than the ED when seeking medical care for concussions. This alone could save an individual family thousands of dollars.
  • The community’s increased awareness about concussions, thanks to the grassroots efforts by Righttime, means that adult and child athletes in the community are safer and healthier.
  • The company benefits by offering a novel service line, generating additional top-line revenue at little incremental cost, because the testing is computerized and based on software that all patients can use. Furthermore, the currently employed physicians and midlevel staff members have the education to evaluate and treat concussions, and the center does not need additional equipment. Only the most severe concussion cases require a computed tomography scan to rule out internal bleeding, and those patients would likely be sent to an ED. In short, the equipment and medical expertise are already present at Righttime (and most every urgent care organization) to offer this service.
  • Righttime benefits by expanding its patient base, which drives additional urgent care visits, unrelated to concussions, because of increased awareness of the Righttime brand.

Conclusion
Urgent care providers looking to differentiate their sports physical program could consider implementing concussion care services similar to Righttime’s successful model. The neurocognitive-assessment software ImPACT is available online and easy to use, the clinical expertise is present, and no additional equipment is needed. A concussion care service line could generate additional revenue for any urgent care operation, provide an inroad to local sports organizations, and expand the center’s patient base. Finally, the service fits nicely into the niche urgent care seeks to fill: a cost-effective option for immediate access health care without waiting days or weeks an appointment with a primary care provider, and without the exorbitant costs of a visit to an ED.

Figure 1. Student athletes take baseline neurocognitive tests at Righttime so that results are available for comparison should they sustain a concussion in the future.
Figure 2. Stanford J. Coleman, MD, conducts a head examination.

Concussion Care Adds Value to an Urgent Care Sports, Camp, and School Physical Program

Alan A. Ayers, MBA, MAcc

Chief Executive Officer of Velocity Urgent Care, LLC and is Practice Management Editor of The Journal of Urgent Care Medicine
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