How a gas station company expanded into healthcare

Over the last 10 years, the urgent care market has doubled in size as more patients, particularly those who are younger, are drawn to their convenient same-day appointments and extended hours. And as the industry continues to grow, more companies, including those originally outside of healthcare, are entering the space.

In late 2020, QuikTrip, a gas station and convenience store chain based in Tulsa, Oklahoma, announced plans to open a new urgent care company called MedWise. Although the company's venture into healthcare may seem unexpected, it was actually several years in the making, according to Sable-Smith.

For years, QuikTrip had been providing its own employees with primary care services, first through third parties and then at its own clinics. Then, five years ago, the company wanted to figure out how it could offer similar medical services to the public.

According to Brice Habeck, a longtime QuikTrip employee who is now executive director of MedWise, his team quickly realized that urgent care shared several similarities with the company's retail spaces. "It’s about access," he said. "It's about convenience."

So far, MedWise has 12 clinics, all of which are in the Tulsa area. Although QuikTrip owns the company, MedWise's clinics are housed in separate locations rather than being attached to existing gas stations.

Lou Ellen Horwitz, CEO of the Urgent Care Association, said she was initially skeptical about QuikTrip's urgent care venture, but the more she thought about it, the more she could see how the two business models could overlap. Just like its retail stores, the urgent care clinics are in easy-to-find locations, cater to walk-in customers, and accept multiple payment methods.  

MedWise plans to open four more locations in northeastern Oklahoma this year and could expand into other states over the next few years. According to Habeck, state healthcare rules, public insurance payment rates, and locations of existing health systems will affect where new clinics are opened.

How will urgent care and retail clinics impact healthcare?

Over the last few years, retailers, including CVS, Walgreens, Walmart, and Target, have increasingly expanded into the healthcare space, with many opening their own clinics. These clinics, combined with a growing number of urgent care centers, offer patients more convenient access to care.

However, even with the added convenience of these clinics, health experts say they may not significantly lower healthcare costs or decrease wait times for care, especially in the long term.

For example, a study published in HealthAffairs found that urgent care clinics reduce less serious ED visits, but 37 urgent care visits are needed to prevent one ED visit, which then increases total healthcare spending.

Separately, ongoing research from Kevin Griffith, an assistant professor at Vanderbilt University, suggests that new urgent care or retail centers can initially decrease wait times at nearby public and private health centers, but over time, the increased access also leads to increased demand and wait times go back up.

"It's kind of like the 'build it and they will come' of health care," Griffith said. However, he added that even though urgent care or retail clinics may not decrease costs or wait times, patients are still getting care. "There is a huge problem with unmet care in the United States. And so ostensibly, these clinics are making a dent into that problem as well."

In addition, even successful businesses may not do well financially as they pivot to healthcare. According to Ateev Mehrotra, a health policy professor at Harvard Medical School, "[g]enerally people have been happy with the convenience" of urgent care or retail clinics, but they have not been very profitable, which has led to several closures.

Still, even with these challenges, Horwitz said that the industry is booming, and many companies are scaling up their clinics rapidly. Currently, more urgent care chains than ever before have triple-digit locations. "Nobody's at 1,000, but some are closing in on it," she said. (Sable-Smith, KFF Health News, 8/16)

How do patients select their primary care physician (PCP), their specialist, or their site of care? These questions are top-of-mind for providers trying to attract and retain consumers and for health plans striving to promote in-network utilization. Advisory Board conducted a consumer study of over 3,000 privately insured Americans to better understand patient expectations and preferences. Read on for three insights on how patients choose where to receive care in 2023.