If you live close to or in a city, chances are you pass an urgent care center when you’re out and about running errands or going to work.
Michael Scott likely did too, and imagine how much time he could have saved after a grill tried to devour his foot had he gone to his neighborhood urgent care instead of hijacking Dwight’s CT scan.
Urgent care serves a valuable purpose. Beyond the (likely) shorter drive, some sources say it's 10x cheaper than receiving the same service at a hospital. And we’ve seen estimates of urgent care being able to do 60-70% of the services performed at a hospital.
Urgent care centers have become a mainstay in most cities, and they also now have an opportunity to use price transparency data as the backbone of their market expansion and pricing strategy.
Data Specificity and Individualized Results By Geography
Urgent care practices are seeing an increasing number of patients and, as a result, are frequently looking to expand. Incorporating price transparency data into that decision-making process can be helpful.
Urgent care practices can research the cost of care in a new market. Like dropping a pin on the maps app, the data contains location-specific filters, extracts, and visualizations based on city, state, zip code, or core-based statistical area (CBSA), so you’re able to drill down into rate information for relevant CPTs and what your negotiated rates could be in a new location.
Knowing what a new location would be charging and expecting as reimbursement lays a foundational business plan for intelligent expansion plans that have a clear understanding of cost and revenue potential.
Using Price Transparency Data For Urgent Negotiations
Pun intended. Anywho. We’ve also worked with practices looking to go in-network with a new insurer. Practices want to know the revenue implications based on the payer’s average in-network rates for specific codes within a specified geographical area. That negotiation process is as fun and efficient as getting into an airport security line that’s so long and snaked you can’t see where in the airport you’ll end up.
For example, we can use a code for a forearm X-ray in Denver, CO. In the entire library of publicly-available rates, results can be as clear as a single average negotiated rate. Looking at the screenshot below, the data confirms a noticeably higher negotiated rate for the X-ray when completed in an outpatient hospital setting as opposed to urgent care setting, which is displayed as a Unit Price Benchmark:
The broader set of price transparency laws aims to level the playing field and minimize back and forth within negotiations because all parties can access the same rates from the start. Skipping this step is a missed opportunity to go into negotiations prepared.
If You Build a Competitive Rate Structure, They Will Come
Access to these rates will likely confirm what practices have suspected (or known) all along: urgent care rates are competitive. They can be used to educate patients on how to avoid spending more money on unnecessary trips to the ER. Adding a layer of benchmarking between hospital ER and urgent care rates can bolster community marketing and awareness efforts.
What does urgent care offer; shorter wait times, lower costs, and flat-fee payments for self-pay patients? These qualitative and quantitative benefits can now be vocalized. Take the first step, search those codes, and let us know what you think. Try Rate Sense, free.