DX / Differentials / URGENT CARE

D-05 — PREPARING FOR SALE · URGENT CARE

Growth has to read as a system — urgent care

Making the visit growth read as a system rather than a good flu season

DIFFERENTIAL — LIKELY CAUSES, MOST LIKELY FIRST

1. 01

   The growth series is a seasonality and respiratory-season artifact — and diligence will find it

   A 39-point annual swing plus two consecutive strong respiratory quarters can manufacture a growth story out of a flat business. A buyer normalises for it; you should first.

   On an average day in July there are 14% fewer patients than baseline and in December 25% more. Both 2023 and 2024 produced an early Q4 "quademic" — influenza, COVID, RSV and strep — with higher-than-average volumes. Experity's own case-mix reading shows the base is broad and non-respiratory: "other" visits run roughly 18–19 per day year-round while respiratory visits expand to roughly 10–13 per day at peak.

   Practice Velocity study of more than 20,000,000 patient visits over five years via JUCM Developing Data, 14 Dec 2016; Experity EMR via JUCM (Ayers), 27 Feb 2025; Experity urgent care visit data page

   NOT THIS IF — Your same-month year-over-year series grows in April through October as well. Then the growth is in the base, not the amplitude.

2. 02

   Same-store growth claims in this vertical are contested, and a buyer's analyst knows it

   The number most operators quote has no named primary and is contradicted by the vendor-neutral claims data. Quoting it invites the diligence team to distrust everything adjacent to it.

   The widely repeated "4% to 7% annual growth in same-center patient volumes" appears in trade press with no named primary. Against it, Trilliant Health's all-payer claims analysis finds non-COVID utilisation grew 18.9% across four years — roughly 4.4% a year — while non-COVID average patient panels by Q2 2023 were only 3.5% higher than Q2 2019. FAIR Health separately shows urgent care's share of commercial claim lines falling 12% from 2022 to 2023.

   JUCM, 31 May 2022 (no named primary — recorded as a conflict in the ADMEN register); Trilliant Health, 12 May 2024; FAIR Health FH 2025 white paper

   NOT THIS IF — Your same-store series is rebuilt from the EMR, excludes COVID-era testing volume and de novo ramp, and reconciles to collections. Then it stands on its own evidence.

3. 03

   The volume is unattributed and nothing in the industry will attribute it for you

   Growth that cannot be traced to a source reads as luck. In this vertical, no external dataset exists to borrow — if you did not build the attribution, it does not exist.

   Across 51 catalogued sources in this vertical, nothing is published on marketing attribution, channel mix, or the path from search or map listing to a walk-in visit. Google review content has been analysed at scale — 3.1 million reviews across 3,665 centers — but the path from impression to arrival has not. Compounding it, 83% of intake still happens in the lobby: only 17% of patients complete registration online before the visit.

   ADMEN source harvest, emergency-urgent vertical, 2026-07-25 (51 sources catalogued, documented gap #9); UCA 2022 Operations Benchmarking Report, p.21 (n=1,055)

   NOT THIS IF — You already record a source and a first-visit flag against every visit in the EMR and can produce a cohort view on request.

4. 04

   The employer book is the transferable asset and it is thin

   Walk-in volume is a function of location and season. Contracted employer revenue is recurring, named, and transfers with the entity — which is exactly what a buyer is paying a multiple for, and it is built by named-account selling into local employers rather than by media.

   The top 20% of clinics draw 29% of total volume from employer-paid and workers'-comp payers, averaging 12 occupational-medicine visits per day; the bottom 20% average fewer than 1. 80% of total occ-med volume sits inside enterprise networks. Median across the industry is 5 occ-med plus 4 workers'-comp visits a day out of 56 total — 16.1%, consistent with UCA's 2018 finding of 16.4% of total patient volume.

   Experity / Urgent Care Consultants via JUCM Developing Data, 29 May 2026; UCA 2022 Operations Benchmarking Report p.9 (n=775); UCA 2018 Benchmark Study via JUCM, 31 Oct 2019

   NOT THIS IF — Occupational medicine is already a documented, contracted, named-account share of your volume with signed terms a buyer can read.

5. 05

   The comparables you and the buyer will both quote are not sourced

   Urgent care lacks the structural denominators every other healthcare vertical has. Walking into a process without your own audited unit economics means accepting someone else's unsourced number.

   There is no NAICS code for urgent care — it is scattered across "offices of physicians" and "all other outpatient care centers" — so the Census Economic Census and County Business Patterns cannot produce revenue per establishment for this vertical at all. The only public revenue-per-location range ($1.5M–$2.5M) and the EBITDA-multiple bands in circulation come from an investment bank citing a research aggregator, with no disclosed sample, transaction count or method. Separately, the widely quoted "$250,000 patient lifetime value" traces, through a trade-journal footnote, to a marketing blog post describing a hypothetical persona — no denominator, no method, no dataset.

   ADMEN source harvest, emergency-urgent, gaps #1 and the UNSOURCED register; FOCUS Investment Banking, 17 Mar 2026, citing Scope Research — recorded as do-not-publish; Solv Health provider blog, 28 Mar 2023, traced from JUCM, 30 Jun 2026

   NOT THIS IF — You already hold a QoE-grade unit-level P&L with rent, supplies, labour and hours per site, built off the general ledger rather than a model.

HOW TO TELL THEM APART

How to tell these apart in your own numbers

Each of these is a measurement you can run yourself, without us.

WHAT RESOLVES EACH

What resolves this, and how you will know it resolved

The growth series is a seasonality and respiratory-season artifact — and diligence will find it	Rx 04 · marketing attribution →	A seasonally indexed same-store series built from your own history, presented alongside the raw one. Doing this before diligence rather than during it is the difference between demonstrating rigour and being corrected.
Same-store growth claims in this vertical are contested, and a buyer's analyst knows it	Rx 05 · preparing for sale →	Rebuild the growth series with a stated method and a constant center set, and retire the 4–7% industry claim entirely. It has no named primary and the vendor-neutral claims data contradicts it. A number you can defend beats a number that flatters.
The volume is unattributed and nothing in the industry will attribute it for you	Rx 04 · marketing attribution →	Source capture at intake plus a first-visit flag. This takes time to accumulate, which is the argument for starting it well before a process — a twelve-month attributed series cannot be created retroactively, and there is no industry dataset to substitute for it.
The employer book is the transferable asset and it is thin	Rx 01 · patient acquisition →	Named-account B2B selling into the trade area's employers. This is the one growth investment in the vertical that also raises the quality of the revenue rather than only its quantity — contracted, recurring, transferable. What does not work: consumer media, which cannot sell an employer contract.
The comparables you and the buyer will both quote are not sourced	Rx 05 · preparing for sale →	We will not hand you a multiple, because no credibly sourced urgent care multiple exists — every published band we could trace runs back to an aggregator with no disclosed sample. We will hand you an auditable unit-level story and a documented method. If a buyer or an adviser quotes the $250,000 lifetime-value figure or the $1.5M–$2.5M revenue-per-location range at you, both are traceable to marketing content, and knowing that is worth more than a number.

HOW THIS DIFFERS BY SCALE

How this differs by scale

Single site	One center. The realistic buyer is a regional operator or a physician group, and the diligence is short. What matters most is a clean, rebuildable visit series and a P&L with rent, supplies and hours that stand up — plus whatever employer accounts exist, because that is the only recurring revenue in the building.
Group	Two to ten centers. This is where the same-store definition starts to matter: a de novo opened mid-period will inflate the network number and a buyer will strip it out. Fix the center-set convention and the seasonal index first, then the attribution. Occ-med concentration across sites will also be uneven and should be documented site by site rather than blended.
Platform	Multi-metro. 40% of the country's 14,442 centers are operated by a top-100 entity and 17% sit inside PE-backed platforms, so the counterparty is sophisticated and has seen the seasonality trick before. Expect the metro-level panel spread (+365% to −72%) to be used against a blended growth number. Lead with per-metro normalisation, a documented attribution method, and the contracted employer book — those three are what distinguish a system from a good respiratory season.

OTHER PRESENTATIONS — URGENT CARE

• Flat VCPD in a catchment that added centers faster than it added visits
• Cost per visit is climbing — and there is no published benchmark to check it against
• The lobby fills and empties — and the employer book is close to zero
• Same brand, same EMR, same hours — one center runs 48 visits a day and another runs 26