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Urgent care clinics nearly doubled in the U.S. between 2014 and 2023, jumping from 7,220 to over 14,300 facilities, according to a Trilliant Health study. That growth wasn't accidental. It tracked a simple consumer demand: people wanted faster, cheaper, more convenient care.
Then telehealth entered the picture, and urgent care operators did something hospitals largely haven't. They treated it as a core product, not a temporary workaround. While large hospital systems debated governance structures and compliance frameworks, urgent care clinics quietly built telehealth programs that patients actually liked using.
The data backs this up. Kaiser Permanente's virtual urgent care program (called Get Care Now) completed 590,000 visits in just the first three quarters of 2024 alone, surpassing the 481,000 total visits from all of 2023. Their Net Promoter Score stayed between 86 and 89 for twelve consecutive quarters. That's not a side project. That's a business model.
Here's what urgent care got right that hospitals keep getting wrong.
Speed Isn't a Feature. It's the Whole Product
Ask any urgent care operator what matters most to patients, and you'll get the same answer: time. The average wait at a five-star hospital is around 13 minutes, but one-star hospitals push past 34 minutes, according to patient experience data from Kyruus Health. Emergency departments are worse. A CDC report found that 45.6% of ER patients waited more than an hour to see a provider.
Urgent care clinics operate on a fundamentally different clock. Roughly 69% of urgent care facilities get patients seen in under 20 minutes. That speed advantage didn't disappear when they went virtual; it actually improved. Kaiser Permanente's data showed that virtual urgent care patients waited an average of 47.7 minutes (including queue time), compared to 68.9 minutes for physical urgent care visits. And the virtual number doesn't include the time spent driving, parking, and sitting in a waiting room.
Hospitals, by contrast, tend to bolt telehealth onto existing workflows. The scheduling system stays the same. The intake forms stay the same. The patient portal adds a video button, and leadership calls it "telehealth integration." But matching the patient's expectation of speed requires rethinking the entire workflow from scratch, not just adding a camera to the old one.
Urgent care clinics understood this instinctively because speed was already their competitive edge. They designed their virtual programs to protect that advantage.
Building the Right Technology Stack (Not Just Buying One)
This is where the gap between urgent care and hospitals becomes most visible. Urgent care operators tend to pick technology that does a few things well: quick patient intake, reliable video connections, straightforward documentation, and fast prescription routing. They don't need a platform that handles 47 specialties. They need one that handles sore throats, rashes, UTIs, and minor injuries without friction.
Hospitals usually approach the decision differently. They look for enterprise platforms that integrate with existing EHR systems across dozens of departments, satisfy compliance teams, and pass IT security reviews. The procurement process alone can take 12 to 18 months. By the time the platform goes live, staff have already lost enthusiasm, and patients have found alternatives.
The smarter approach sits somewhere in the middle. Organizations that invest in telemedicine software development tailored to their specific patient flows tend to outperform those using generic, off-the-shelf solutions. That's because purpose-built systems can match how your clinic actually works instead of forcing your team to adapt to someone else's template.
Consider what the most effective telehealth tech stacks typically include:
Lightweight intake workflows that collect only what's needed for the visit type, not a 47-field registration form designed for inpatient admissions
Asynchronous messaging capability that lets patients describe symptoms before the live visit, cutting consultation time by several minutes
Smart routing logic that matches patients to available providers based on complaint type and acuity, not just whoever is "next"
Integrated prescription and referral tools so the visit ends with an action, not a promise to "send something over later"
Hospitals often skip these details because they're focused on checking enterprise compliance boxes. Urgent care clinics focus on them because each wasted minute costs them a patient.
Reimbursement Realism vs. Regulatory Paralysis
One of the biggest reasons hospitals drag their feet on telehealth is reimbursement uncertainty. And it's not an irrational concern. The Congressional Budget Office has estimated that extending pandemic-era telehealth flexibilities would add $2 billion in additional Medicare spending. That kind of number makes hospital CFOs nervous.
But urgent care clinics moved forward anyway. They did it by concentrating on visit types where reimbursement was already straightforward (low-complexity acute visits), keeping overhead low, and treating telehealth as a patient retention tool rather than a standalone profit center.
Here's the practical difference in how the two models approach reimbursement:
Urgent care clinics focus on high-volume, low-complexity virtual visits (the kind dominated by E/M codes 99211-99213) where reimbursement rates are established and predictable. A 2023 study published in the American Journal of Managed Care confirmed that primary care and urgent care telehealth visits were mainly characterized by low-complexity encounters.
Hospitals try to push moderate-to-high complexity visits through telehealth (codes 99214-99215), which carry higher reimbursement but also higher documentation burdens, more audit risk, and less payer consistency. The same study found that non-primary care specialties saw moderate-level telehealth visits surpass low-complexity ones between 2020 and 2023.
The result: urgent care clinics generate steady, predictable telehealth revenue, while hospitals get stuck in pilot programs that never scale because the financial model is too complicated.
Nearly half of U.S. states now have payment parity laws ensuring telehealth visits are reimbursed at the same rate as in-person care, according to data current as of January 2025. That trend is moving in one direction. Hospitals waiting for "perfect" reimbursement clarity before scaling telehealth will find themselves years behind clinics that started building volume while the rules were still being written.
Letting Patients Choose the Channel
Deloitte's 2024 healthcare consumer survey found that 44% of patients had a virtual visit in the previous 12 months. Of those, 94% said they'd do it again. The most common reason for choosing telehealth over an in-person visit was simple convenience: better appointment times, shorter waits, and easier scheduling.
Urgent care clinics leaned into this. Many now offer patients a real choice at the point of access. Feeling well enough to stay home? Book a virtual visit. Need hands-on care? Walk in. The hybrid model works because patients can self-select based on their own judgment about what they need.
Kaiser Permanente's data illustrates an interesting detail about who chooses virtual urgent care. Their virtual program skewed toward patients aged 30 to 49 (39.7% of virtual visits versus 29.9% of in-person urgent care visits). Women were also more likely to use the virtual option: 61.6% of virtual urgent care patients were female, compared to 54.9% of in-person patients.
Hospitals, on the other hand, often restrict telehealth to specific departments or conditions. You can get a virtual behavioral health visit but not a virtual urgent care consult. You can message your primary care doctor through the portal, but if you need same-day attention, your options are "come in" or "go to the ER." That's not a channel strategy. That's a gap in service.
The mental health numbers underscore this further. Behavioral health and psychiatry are the only non-primary care specialties where telehealth visits actually grew post-pandemic, according to the American Journal of Managed Care. Telemedicine usage in mental health was more than three times higher than in other medical specialties in 2023, per Epic Research. Patients in these categories already proved they'll choose virtual when it's available. The question is whether hospitals will offer that same choice across their other service lines.
The Staff Problem Nobody Talks About
Telehealth isn't just a patient-facing tool. It's a staffing strategy. And this is another area where urgent care clinics have been faster to adapt.
A McKinsey report found that nearly 20% of provider time is wasted due to last-minute cancellations and rescheduled appointments. Telehealth reduces no-show rates because the friction of attending is lower. You don't need to drive somewhere, find parking, or take a half-day off work. You just log in.
Urgent care clinics leveraged this to run leaner operations. Fewer exam rooms needed per provider. Less front desk overhead. More flexible provider schedules, because a physician doing virtual visits can work from a different location than the physical clinic.
Hospitals face a different challenge: they have large, complex staffing models that don't flex easily. Shifting 10% of urgent visits to telehealth might mean 10% of physical exam rooms sitting empty, which creates a different set of budget headaches. But the net effect for patients is the same: hospitals that don't offer virtual options are losing low-acuity visits to competitors that do.
The American Medical Association has estimated that about 70% of primary care visits and 40% of emergency department visits could be handled at a lower-acuity setting. That's a massive volume of patients whose needs are being met in the wrong place. Urgent care clinics, particularly those with strong virtual programs, are positioned to absorb a significant portion of that demand.
What Hospitals Can Actually Do About It
Hospitals don't have to become urgent care clinics. But they can stop treating telehealth like a pilot and start treating it like infrastructure. The urgent care playbook boils down to a few clear moves:
Design for speed first. Audit your virtual visit workflow end to end. If a patient can't go from "I feel sick" to "I'm talking to a provider" in under 15 minutes, something is broken.
Build or buy technology that fits your actual visit types. Stop trying to make a single platform work for dermatology, cardiology, urgent care, and behavioral health. Different visit types need different tools.
Start with low-complexity, high-volume visits. Don't launch telehealth with your most complicated service line. Build volume and confidence with straightforward acute care visits, then expand.
Give patients real choice at the front door. If someone calls your scheduling line with a sore throat, "Would you prefer a virtual visit or an in-person appointment?" should be a standard question, not an exception.
Track the right metrics. Stop measuring telehealth by visit volume alone. Track time to provider, patient satisfaction, no-show rates, and downstream utilization (did the virtual visit prevent an ER visit?).
The direct-to-consumer telehealth market was valued at $1.47 billion in 2023 and is projected to grow at a compounded annual growth rate of 30.3% through 2030, according to market research cited in a PMC-published study. That growth isn't coming from hospitals. It's coming from companies and clinics that figured out what patients actually want.
Urgent care clinics don't have bigger budgets or fancier technology than hospital systems. They have fewer bureaucratic layers and a stronger incentive to move fast. Hospitals that want to compete in virtual care don't need a bigger strategy deck. They need to study what's already working two miles down the road and ask themselves a simple question: why aren't we doing that?
