Funyuns and flu shots? Gas station company ventures into urgent care

The urgent care industry’s market size has doubled in the last decade.

Bram Sable-Smith writes for KFF Health News.

TULSA, Oklahoma — Lou Ellen Horwitz was skeptical when she first learned that a gas station company was planning to open a chain of urgent care clinics.

Horwitz, as CEO of the Urgent Care Association, is well aware that the industry is thriving. Its market size has more than doubled in the last decade, as patients, particularly younger ones, are attracted to the convenience of same-day appointments and extended hours provided by walk-in clinics.

“Urgent care is harder than it looks,” Horwitz recalled thinking when Tulsa-based QuikTrip announced an urgent care venture called MedWise in late 2020. “And that’s a whole different ballgame than selling Funyuns.”

However, Horwitz stated that the more she thought about it, the more she saw similarities between the business models of QuikTrip and successful urgent care clinics, such as setting up in easily accessible locations, catering to walk-ins, and accepting multiple payment methods. She reasoned that QuikTrip opening health clinics might make sense if they could provide quality medical care.

Indeed, QuikTrip had been providing primary care services to its own employees for years, first through third-party providers and then through its own clinics. Longtime “QuikTripper” Brice Habeck was tasked five years ago with leading a team to figure out how the company could offer such medical services to the general public as well. His team quickly realized that urgent care and retail had a lot in common.

“It’s all about access.” “It’s all about convenience,” explained Habeck, who began his career as a clerk at a QT, as the stores are commonly branded, and is now the executive director of MedWise.

MedWise has so far opened 12 clinics in the Tulsa area and has joined Horwitz’s trade group. QuikTrip owns the company, but the two companies do not share buildings or a name. People love gas stations, but company leaders didn’t want patients to think the person checking their vitals had just wiped down a gas pump, according to Habeck.

QuikTrip is not the first company to recognize the value of the urgent care industry. For more than a decade, private equity firms have been investing in the consumer-friendly niche of urgent care. And nearly half of urgent cares are affiliated with hospital systems, which frequently see urgent care as a front door for bringing in new patients while relieving pressure on their overburdened emergency rooms.

Other retailers have seen opportunities to expand into patient care as well.Walmart, Target, CVS, and Walgreens have all opened “retail clinics” in recent years, often in their existing stores and frequently in collaboration with local health systems to provide actual medical care. According to Horwitz, the scope of services available at urgent care centers, such as MedWise clinics, is generally greater than that of retail clinics.

However, urgent care and retail clinics may not be the cure-all for rising health-care costs. According to a study co-authored by Harvard Medical School health policy professor Ateev Mehrotra, urgent care clinics reduce less serious visits to the emergency room, but 37 urgent care visits are required to prevent a single ER visit, increasing total health care spending with all of those trips.

Furthermore, ongoing research by Vanderbilt University assistant professor Kevin Griffith suggests that newly built urgent care or retail clinics can initially reduce wait times at nearby private and public sector health centers. However, he is discovering that the increased access provided by the new clinics eventually increases demand, and wait times creep back up.

“It’s kind of like the ‘build it and they will come’ of health care,” Griffith said, adding that while the clinics may not reduce wait times or costs in the long run, they do get patients seen. “Unmet care is a huge problem in the United States.” And, ostensibly, these clinics are also making a dent in that problem.”

According to Mehrotra, the experience of some retail clinics serves as a cautionary tale for companies like MedWise: disrupting the health care industry is easier said than done, even for businesses with a successful track record of good customer service in a low-margin business like gas stations.

“Generally, people have been happy with the convenience,” Mehrotra said, but the clinics have not been profitable, prompting many closures over the years.

Gas stations are used to competing for customers by providing something unique. QuikTrip, for example, was recently ranked ninth on a list of the best gas station brands in America, with QT’s “beloved” made-to-order food, such as breakfast tacos, being highlighted. Habeck believes that patients today are open to a more transactional approach to health care.

That doesn’t mean serving roller-grill hot dogs and taquitos in urgent care waiting rooms, though Habeck joked that if MedWise hadn’t launched during the pandemic, it might have tried. Rather, he claims, the chain is banking on gaining customer loyalty by providing patients with consistent service but not necessarily a consistent clinician.

And, while MedWise and QTs are not in the same building, Habeck claims that the parent company’s experience finding prominent locations for gas stations is useful for placing urgent cares as well.

Billy Rohling and Amy Shaver were waiting for their ride home on a recent Friday afternoon in the mostly empty parking lot of a MedWise off Interstate Highway 244 in Tulsa. Rohling, 56, recalls when this corner of Admiral Place and Sheridan Road was a shopping center with tenants such as J.C. Penney Co. and TG&Y, a five-and-dime.

Those stores, however, are long gone. Shaver, 37, was having breathing difficulties when the couple arrived at MedWise. This was her second visit to the clinic.

“They’re not at all busy,” Rohling said. “It took about 15 minutes to get an EKG.”

Indeed, MedWise’s patient visits have slowed since the unexpected “windfall volume” that resulted from opening during the pandemic, according to Habeck. At one point, MedWise clinics provided curbside covid-19 tests to hundreds of patients per day, the majority of whom paid cash. All of those visits helped propel the clinics through unusually low flu seasons in 2020 and 2021, which are typically urgent care’s bread and butter.

However, Habeck stated that MedWise is still on track to grow. Four more MedWise locations are set to open this year in northeastern Oklahoma, and the future should see even more MedWise locations in QuikTrip’s 17-state, 1,000-location footprint, including Kansas City, Missouri, and Wichita, Kansas.

State health care rules, public insurance payment rates, and existing health system locations will all play a role in where the new clinics are located, according to Habeck, though expansion outside of the state is likely a few years away.

Scaling up in the industry, according to Horwitz, necessitates a degree of standardization — everything from clinic layouts to staffing levels, and even where various supplies are stored — which can be difficult to achieve. However, she stated that it is a trend, with more urgent care chains having triple-digit locations than ever before.

“No one has reached 1,000, but some are getting close,” Horwitz said.

KFF Health News, formerly known as Kaiser Health News (KHN), is a national newsroom that produces in-depth health journalism. It is one of KFF’s core operating programs — the independent source for health policy research, polling, and journalism.