Urgent care reimbursement is broken. Urgent care is paid the same rate by Medicare as regular medical offices despite having having higher capital investment and ongoing expenses to support acute conditions. Furthermore, urgent cares have a proven ability to reduce costly emergency room utilization but have yet to capture the benefit of reducing cost to the overall healthcare system.

Urgent ACO is rebuilding the urgent care payment model from the ground up. By offering fixed monthly payments for attributed Medicare patients, Urgent Care Centers who participate in the ACO can receive an average 80% increase in payments per year and achieve year-round revenue stability. This translates to $75k additional a year per urgent care center.

This is only possible through participation in a couple of innovative payment arrangements directly with the Center for Medicare and Medicaid Services (CMS). The foundational program is called the Medicare Shared Savings Program where Urgent Care Centers can participate in an Accountable Care Organization or ACO. Additionally, the ACO is applying for the flex model that provides upfront funding and fixed monthly payments to urgent care providers.