ADDED VALUE An orthopedic urgent care center is an ongoing source of revenue for surgical referrals and follow-up care.

It's 6 p.m. on a Saturday. A high school athlete with a bad ankle sprain and a weekend warrior with a fractured wrist sit in a hospital's ER. Hours pass as they wait to be seen by a physician, who may or may not be an orthopedic specialist.

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.

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.

We see our clinic 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 patients come in with fractured wrists, you stabilize them, treat their pain and triage them to an orthopedic specialist who can provide them with the appropriate care. 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. Being an ortho-only urgent care center might let you 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. OSM

PROFIT POTENTIAL
Ortho Clinics Ramp Up Revenues

THUMBS UP ROC Express became a profitable venture within a year of opening.

When Reno (Nev.) Orthopaedic Clinic opened ROC Express in 2014, the orthopedic urgent care center literally and figuratively broke new ground. The fledgling center had plenty of competition from the likes of hospital emergency departments and other urgent cares, but this was the first urgent care in the region staffed by physician assistants and supervised by surgeons devoted solely to orthopedic care.

In its first year — after the practice spent $1.6 million on construction, administration, marketing, imaging and 12 months of labor and staffing — the urgent care brought in more than $2.5 million in revenue. At the same time, revenue from the follow-up care of patients who entered the practice through the urgent care exceeded $7.6 million over the same time period.

The findings of a 12-month study of the urgent care clinic may help to explain the clinic's success (osmag.net/AMTr3n): The average charge for an urgent care visit was $461, compared with $8,150 for a local trauma center's emergency department; the average visit time was 43 minutes in the urgent care, versus 156 minutes in the ER; and the average time to be seen by an orthopedic specialist was 1.2 days in the urgent care and 3.4 days for ER patients.

— Bill Donahue