Becker’s Healthcare Podcast Summary Episode: Healthcare Upside/Down: Pearls and Pitfalls for Integrated Urgent Care Strategies Release Date: July 14, 2025

Hosted by Molly Gamble, this episode delves into the evolving landscape of urgent care in the U.S., exploring both the opportunities and challenges associated with integrated urgent care strategies. Joining Molly are Nick Zima, Vice President of Corporate Development at Wellstreet Urgent Care, and Katie Fellin, Partner at ECG Management Consultants.

1. Introduction to Guests and Their Expertise

Molly Gamble opens the episode by introducing the guests:

• Nick Zima brings over a decade of experience in developing and operating ambulatory strategies at Wellstreet Urgent Care. His focus is on creating patient-centric and financially sustainable urgent care models that seamlessly integrate with health systems.

  “Urgent care to an outside observer might seem simple, but it is not. It is an incredibly difficult service line and function to master despite having become such a crucial access point into today's healthcare ecosystem.”
  — Nick Zima [00:33]

• Katie Fellin is a partner at ECG Management Consultants, specializing in payer strategy and contracting. With extensive experience since 2007, Katie supports a diverse range of clients, including hospitals, health systems, and urgent care providers, helping them navigate reimbursement strategies and negotiations with payers.

  “We're still very early on this, but I actually have some optimism about that. When the service is relatable, it makes the discussion around what the payer values and what their employers value.”
  — Katie Fellin [26:47]

2. The Growing Urgent Care Market

Nick Zima provides a comprehensive overview of the urgent care market's expansion:

• Market Growth: Since 2007, the number of urgent care centers has grown by approximately 7-8% annually, reaching about 14,000 to 15,000 centers nationwide. The market was valued at approximately $47 billion in 2024 and is expected to continue its upward trajectory over the next five years.

  “Every year since 2007 or 2008, there has been an addition of roughly 7 to 8% unit count growth. So it has been a pretty meteoric rise in just urgent care center count nationwide.”
  — Nick Zima [04:25]

• Patient Volume: In 2024, Wellstreet Urgent Care served over 2.1 million patients across 150 centers, emphasizing their commitment to high patient throughput without compromising clinical quality or patient experience.

• Integration with Health Systems: A key differentiator for Wellstreet is their strategy of integrating urgent care centers within health systems' EMR (primarily EPIC) and maintaining the health system’s branding. This ensures a seamless patient experience and reinforces trust.

3. Shifting Patient Preferences and Accessibility

Nick Zima highlights critical trends affecting patient behavior:

• Decline in Primary Care Loyalty: Approximately one in two Americans no longer maintains a relationship with a primary care provider. This decline has pushed patients towards urgent care centers as their primary access point for non-emergency healthcare needs.

  “Our market research kind of found that exact data point again, where what we were seeing is patients don't maintain that loyalty anymore.”
  — Nick Zima [04:41]

• Avoidance of Emergency Rooms: A significant majority (65-70%) of patients prefer to avoid the ER due to high costs and long wait times. Urgent care provides a more convenient and cost-effective alternative.

  “Patients resoundingly want to avoid the ER. No one likes getting the high, the extremely high bills. No one likes to sit in a waiting room for two hours, three hours.”
  — Nick Zima [07:03]

4. Urgent Care’s Value Proposition and Cost Implications

The discussion shifts to the financial aspects of urgent care:

• Cost Savings vs. Increased Spending: While some studies suggest that urgent care may lead to increased overall spending on lower acuity care, Nick counters that urgent care fills a necessary gap, preventing more expensive ER visits and providing essential care efficiently.

  “There's really only one other avenue of approach excluding urgent care, and that's the ER... patients are going to pick that and have that 5x to 20x savings.”
  — Nick Zima [12:04]

• Reimbursing the True Value: Despite potential cost savings, the fragmented reimbursement landscape poses challenges. Katie Fellin elaborates on how payers often do not recognize the comprehensive role urgent care plays, categorizing it as a specialty rather than primary care, which affects reimbursement rates.

  “Payers generally view urgent care as a necessary subspecialty, but not really as primary care.”
  — Katie Fellin [12:30]

5. Reimbursement Challenges in Urgent Care

Katie Fellin delves into the intricacies of reimbursement:

• Discrepancy Between Provider and Payer Goals: Urgent care centers prioritize enhancing patient experience and operational efficiency, which can lead to higher costs. However, payers focus primarily on controlling costs, often disregarding the additional investments made to improve patient satisfaction.

  “Urgent care centers are being designed to maximize the consumer and patient experience... but reimbursement from payers really only factors in the cost to deliver basic care.”
  — Katie Fellin [12:30]

• Primary Care Integration Issues: Urgent care centers are not typically seen as primary care by payers, limiting their access to higher incentive payments that primary care providers receive within value-based reimbursement models.

  “When you're thinking about the transition to value or value based reimbursement models, primary care providers typically have the attributed lives and yield the higher incentive payments. Urgent care is fundamentally helping to close those care gaps... but they're generally being treated as specialists with lower level incentives.”
  — Katie Fellin [14:25]

• Medicaid Reimbursement Problems: A significant number of urgent care centers opt out of Medicaid participation due to lower reimbursement rates, hindering access for Medicaid populations and exacerbating care gaps.

  “Reimbursement for Medicaid... many urgent cares across the country have opted out of Medicaid participation and are serving commercial patient populations only.”
  — Katie Fellin [16:00]

6. Innovations to Enhance Patient-Centric Care

Nick Zima discusses how Wellstreet Urgent Care is innovating to keep patients at the center:

• Integrated EMR Systems: By utilizing health system partners' EPIC instances, Wellstreet ensures seamless data integration, enhancing continuity of care and facilitating better clinical decision-making.

• Advanced Testing Capabilities: Wellstreet has invested in in-house PCR testing for respiratory illnesses and sexually transmitted infections (STIs), enabling rapid diagnosis and treatment within the clinic. This not only improves patient outcomes but also supports antibiotic stewardship.

  “We just rolled out an STI PCR test... that patient will be tested and treated. That course of treatment will have begun before that patient ever leaves our clinic.”
  — Nick Zima [20:30]

• Operational Efficiency: Emphasizing minimal friction in the patient journey, Wellstreet focuses on reducing wait times, simplifying access, and ensuring that the urgent care experience is as smooth as possible.

  “How many left hand turns does that patient have to make across four lanes of traffic to access the care once they've found that care? How long is that patient sitting in a waiting room waiting to be triaged...?”
  — Nick Zima [21:30]

7. Strategic Partnerships and Future Growth

Nick Zima highlights the importance of strategic partnerships in expanding urgent care services:

• Health System Collaborations: Wellstreet exclusively partners with health systems, avoiding independent urgent care operations. This strategy ensures brand consistency, EMR integration, and alignment with health systems' broader ambulatory strategies.

  “We only partner with health systems to run urgent cares. We don't operate independent urgent cares nationwide.”
  — Nick Zima [23:14]

• Community Integration: By situating urgent care centers in accessible, high-traffic locations (e.g., near coffee shops or grocery stores), Wellstreet ensures that care is convenient and integrated into the daily lives of patients.

• Transformational Potential: Urgent care is positioned not just as a necessary service but as a strategic asset that can enhance patient acquisition, retention, and overall community health outcomes.

  “Urgent care at times has been looked at as just a necessity, but it doesn't have to be that necessity. This can truly be transformational for health systems.”
  — Nick Zima [23:41]

8. Reimbursement Strategies and Negotiations

Katie Fellin emphasizes the importance of effective negotiation tactics with payers:

• Relatable Discussions: Success in negotiations often hinges on connecting with payer representatives who understand the urgent care specialty, potentially through shared experiences or mutual understanding of patient needs.

  “For example, if we're negotiating for ABA Services for autism... the discussion is a little more real because they know what you're talking about.”
  — Katie Fellin [24:45]

• Employer Perspectives: Employers are increasingly valuing local, cost-effective care solutions that minimize employee downtime. Aligning urgent care services with these priorities can enhance negotiation outcomes.

  “Employers want their employees to come to work and they can come to work faster if they can get access to the care they need faster in the appropriately cost setting.”
  — Katie Fellin [26:00]

9. Conclusion and Final Thoughts

Molly Gamble wraps up the episode by highlighting the nuanced opportunities and persistent challenges within the urgent care space. She thanks guests Nick Zima and Katie Fellin for their insightful contributions.

“Listeners, you can tune in to more podcasts from Becker's Healthcare by visiting our podcast page@beckerspodcast.com.”
— Molly Gamble [26:50]

Key Takeaways

• Urgent Care Growth: The urgent care sector is rapidly expanding, driven by declining loyalty to primary care and patient aversion to ERs.
• Patient-Centric Models: Successful urgent care strategies prioritize patient experience, convenience, and seamless integration with health systems.
• Reimbursement Challenges: Misalignment between provider investments in patient care and payer reimbursement structures poses significant barriers.
• Innovation as a Differentiator: Technological advancements and operational efficiencies are crucial for enhancing patient experience and maintaining competitiveness.
• Strategic Partnerships: Collaborations with health systems are essential for scaling operations and ensuring consistent, high-quality care delivery.

For more insights and episodes, visit Becker's Healthcare Podcast.