Urgent Care Centers: Ownership, Expansion, and Strategy Trends
The urgent care center landscape rapidly evolved over the past decade. Historically dominated by physician-owned clinics, the market saw a shift toward private equity-backed consolidators and large healthcare systems. Today, ownership is increasingly institutional, with players like Carbon Health, CityMD (Summit Health), American Family Care, MedExpress (Optum/UnitedHealth), and Fast Pace Health leading regional and national expansion efforts. Particularly, American Family Care is a standout as it is the largest provider and is one of the few companies that has a franchise model.
Expansion Strategy
Much of the urgent care growth, especially over the last five years, occurred through aggressive acquisition and de novo development. These groups use scalable platforms, centralized operations, and data-driven site selection to enter new markets quickly—often targeting areas with strong household income, growing suburban populations, and limited existing access to same-day care.
Fast Pace Health is one urgent care provider that is notable for expanding its original locations in Tennessee and Kentucky to six other states and rural areas. To aid its expansionary efforts, Fast Pace Health is growing its telehealth service and technology infrastructure to best serve patients. The firm is also increasing its focus on rural areas to aid patients that don’t have as much medical access.
National Urgent Care Performance
Top-performing locations are typically in mid- to high-income suburbs, near busy retail corridors or grocery-anchored centers, and with strong traffic visibility. Urban core locations can be hit-or-miss depending on payer mix and competition, while rural areas can face staffing and patient volume challenges.
In rural locations, if a facility is not part of another network, or if they are an hour away from another clinic owned by the same operator, it becomes difficult to substitute healthcare workers. This trend is most prevalent in the West Plains and creates difficulties when patients require care. However, Midwest and Southeast states have urgent cares close enough to reallocate staff if necessary, which ensures the facility remains open.
Despite difficulties in rural urgent care operations, urgent care properties in rural areas are expanding at the fastest rate nationally. In 2024, rural urgent cares made up 26% of new facilities, compared to 13% for urban areas. The growth for urgent cares in rural areas can be attributed to hospitals shutting their doors in these areas. Over 100 rural hospitals closed over the past 10 years, due to financial difficulties, which left patients with few medical care options. Now, urgent care practices seek to fix this problem, with providers like Fast Pace Health rapidly expanding their operations in rural locations.
Many national brands are expanding into rural locations that are fundamentally too small to support urgent cares. However, rural urgent cares can be attractive opportunities because the payer mix will often include Medicare and Medicaid. These are often enticing to the owner, but investors may encounter difficulties in replacing high rents if the facility stops its operations.
Real Estate and Facility Design
Operators are utilizing flexible real estate, from freestanding buildings and former banks to end-cap retail and purpose-built medical shells. Sites range from 2,500 to 5,000 square feet, often with easy parking and fast in-and-out access, and digital check-ins have also become more common post-COVID-19.
Urgent cares used to be hidden in Class B locations that were often behind a medical park. Since then, they have moved to prime spots in main retail corridors or primary roads. These sites are most sought after by urgent care companies due to their convenient location. Local trade areas have one of the highest impacts on urgent cares, which created positive performance for these providers who were able to spot the difference before their competitors over the past decade.
