Occupational Medicine in Urgent Care: An Additional Revenue Opportunity

By Todd Wilkins, Division President, Occupational Health, Net Health

Do you remember the first time you applied for a job, and they required a physical and possibly a drug screen before they could officially offer you the position?  What about a required annual assessment to maintain an industrial license, such as a Commercial Driver’s License (CDL) or specific hazmat certification?  Do you know someone who works in an environment that can be hard on your ears or even on your lungs?  All of these are handled by occupational medicine clinics and providers.  It is a specialty that focuses entirely on the workforce, and the best part about the industry is that it is immune to federal and state policy changes that limit reimbursement. The relationship between provider and payer is squarely between the practice and the employer. There is no relationship with an insurance carrier to navigate, and no limits on reimbursement fee schedules, as prices are negotiated directly with the employer.

Urgent care practices primarily generate revenue from patient visits and the associated insurance reimbursements and patient out-of-pocket payments. The passing of the One Big Beautiful Bill Act (OBBBA) will significantly impact urgent care businesses as it will increase the uninsured population, which will drive more cases from urgent care centers to the local emergency room, strain finances with cuts to both Medicare and State Medicaid plans, and result in lower reimbursements. This, in turn, will force many patients to delay care. Additionally, as commercial carriers navigate the new changes across the plans they offer, providers will face increased costs and administrative challenges, which ultimately raise insurance premiums and create a vicious cycle.

An often-unexplored source of revenue for urgent care practices is occupational medicine. As I mentioned, the specialty is most often immune to federal and state policy changes, making urgent care and occupational medicine a potentially strong pairing. Urgent care practices can ease into this specialty and start to provide services to local employers such as Department of Transportation (DOT) Physicals and Certifications, pre-employment physicals and drug screens, as well as routine offsite services like annual immunizations and audiometry testing.

Having the right tools is crucial to execute a successful Occupational Medicine program from your urgent care practice. It will require specialized billing software to provide aggregate monthly invoices and statements. Employers do not want to manage a single invoice for every employee they send to your practice, as they do for insurance claims management, which is often a hassle. Remote application capabilities are needed for offsite service offerings. To enhance your service offering and attract employer business to your practice, look for portals specifically designed for your employer clients to monitor the business relationship with your practice, as well as for the employees they send to your practice.

As you grow your occupational medicine business within your practice, you can branch into another segment of the specialty: workers’ comp. This functions differently from both your standard urgent care business and employer services business. While these claims primarily get billed to a carrier, there are very different rules on how the claims must be processed and the reporting requirements for the various injuries, illnesses, and exposures being treated. However, a successful workers’ comp line of business can go hand-in-hand with employer services, as services, such as generation of annual Occupational Safety and Health Administration (OSHA) Logs, Sharps Injury Logs, and hearing conservation monitoring, can be offered to augment the standard workers’ comp assessment and treatment provided to the employees and can provide value to the Employer.

Since their inception, urgent care practices play a vital role in patient care and help to reduce overall burden on an already stressed emergency rooms across the country. Recent policy changes may threaten these businesses, which will result in negative impact on the entire system. Occupational medicine as an additional source of revenue may help these practices weather the storm and continue to thrive and serve their communities with much needed care.