A $50 Urgent Care Visit

Can you imagine a $50 urgent care visit? It doesn’t exist. But is that because it’s not financially sound or because healthcare is rigged?

I don’t know of any cash-pay urgent cares or walk-in clinics. But I know that they are financially sound.

Urgent Care Patient Flow

Patients choose an urgent care or walk-in clinic based on proximity and insurance coverage.
These are 1st-tier reasons.

When it’s cash-pay urgent care, only the proximity matters. With large cities abound, getting enough traffic to a place is not hard if you meet a few other basic criteria.

The 2nd-tier reasons are:

• parking
• clinician competence
• wait times

$50 Per Patient Per Visit

The per-patient-per-visit (PPPV) number is how much you can charge per patient for each visit.

You’re not a publicly traded company, nor a venture capitalist or private equity firm. Why care about maximizing profits when all you need is a living income?

How many of us physicians have figured out how much income we need and what we are willing to do to earn that income?

$50 PPPV x 15 patients/day x 25 days/mo = $18,750

My Ideal Practice Stats

Practice statistics include:

• number of patients per day
• level of tolerable admin work
• number of necessary employees
• profit needs
• stress tolerance

1. Income

What’s the lowest income I’m comfortable with per year? Why the lowest? Because in a solo practice, more income means more work.

$150k of gross income, let’s say.

2. Patient Volume

How many patients can I see in 1 day before feeling exhausted? What acuity can I handle based on my risk tolerance and anxiety levels?

Up to 20 patients in a walk-in or Urgent Care clinic is quite easy for me. At $50 per visit, that’s a nice income.

3. Clinic Hours

How many hours of my day do I want to spend at work? How many days a week do I want to work?

I prefer to work almost daily but only up to 4 hours per day. That’s 20 hours per week or 1,000 per year.

4. Admin Tasks

What kind of headaches am I willing to tolerate? Insurance billing, contract negotiations, employees, complaints, malpractice?

I can handle 1 employee. I don’t want to do any billing other than collect the visit fee.

I don’t care to deal with insurance. I only want to be paid in cash for the office visit. Done.

Customer Acquisition Cost

Customer acquisition cost (CAC) is a fancy word for marketing. But trust me; it’s worthwhile to understand.

Imagine spending $150 in marketing to get a single patient who will come to your urgent care and drop $50. Bad business? Hardly.

This customer will likely return, bring their family members, and tell their church of friends. In fact, it’s best to spend $250 if you can ensure this patient avatar is the ideal fit for your medical practice.

If you have money in the bank, there is no reason to fear spending a little more on acquiring your first few hundred patients.

Running Some Income Numbers

Each clinic has rather similar overheads. I’ve discussed before that onsite lab testing and X-rays add a slight complexity, but generally, it doesn’t add anything substantial to practice.

1. Real Estate

In Southern California, I can buy a small medical office for under $1m and as low as $500k. This works out to be a mortgage of $6,500 per month, on average.

Rent can be as little as $1,000 monthly for a 550 sqft. In this example, let’s go with rent. We’ll assume $2,500 to make it fair.

2. Utilities

10% of the mortgage or rent is a safe number for water, electricity, internet, trash, etc.

10% of a $2,500/mo rent is $250. Fairly accurate.

3. Insurance

We need malpractice, workman’s comp, property insurance, and business insurance. It’s a lot but they are often all lumped in.

Let’s say around $2,500/month for everything.

4. Payroll

In a cash-pay medical practice, billers and accountants are rarely needed. In fact, even a CPA isn’t necessary.

But you might want a medical assistant or LVN or RN. That’s anywhere from $20-50 per hour.

For a medical practice with only 20 service hours a week, that’s $3,000 per month.

5. Supplies

An urgent care will need some point-of-care testing and perhaps some injectable medications. I’ve listed prices for these things in previous articles.

It turns out to be $5-7 PPPV. Let’s say $5 or 10% of the gross income.

Keep in mind that when you see more patients a lot of these numbers improve but that’s exactly the idea I’m trying to avoid.

Example 1: Walk-in Cash Clinic in Compton, CA

This clinic would be located in Compton, California, with a low average household income.

Cities with such an economic makeup are ideal for a cash-pay urgent care or a cash clinic.

Revenue $24k/mo.

Revenue refers to the gross income of a business, and it doesn’t factor in the overhead.

$24k/month. $288k/yr.

Expenses $10k/mo.

Profits $14k/mo.

This clinic owner will be able to write off quite a lot of business expenses which I won’t factor in, but it’s important to understand.

$24k of revenue – $10k of expenses = $14k/mo profits

Or, $168,000 per year.

This is a healthy income for a low-acuity walk-in clinic/urgent care which should get a healthy patient flow because of the low cost of care.

Example 2: Primary Care Clinic in Long Beach, CA

Long Beach has a diverse income population. But the clinic is a cash-pay primary care practice located in a middle-class neighborhood.

Revenue $12k/mo.

$12k/mo. or $144k/yr.

Expenses $5.5k/mo.

Profits

$12k – $5,500 = $6,500/mo.

$78,000 may not sound like much, but this primary care practice is open only 3 days a week and has 30-minute appointments.

Example 3: Pediatric Urgent Care in Culver City, CA

FP or Peds run pediatric urgent cares and often have a PA or NP assisting.

Revenue $35k/mo.

Expenses $13k/mo.

Profits $22k/mo.

A rather lean, cash-based pediatric urgent care can run some onsite labs and send patients out for x-rays or labs.

There is no insurance billing; therefore, the check-in process is easy enough for a PA and the MD/DO to run the clinic together.

There are no mandatory vitals because you aren’t submitting insurance claims. I don’t care about the weight of my patient when I’m seeing them for a small laceration.

Though trauma is a big part of pediatric urgent cares, most of the visits are worried-wells. A bandaid and reassurance is all that’s needed.

If sutures have to be placed or scalp staples, these are inexpensive, and the staples ($15) or suture kit ($20) can be charged directly.