# Urgent Care Model Model an urgent-care business from clinic growth and patient visits through to staffing, cash flow, and valuation. - Canonical: https://finamodel.com/templates/urgent-care - Excel download: https://finamodel.com/templates/urgent-care.xlsx - Category: Healthcare - Model type: Operating model - Difficulty: Intermediate - Audiences: Investors & analysts, Founders & operators, Private equity associates, Health-system strategy teams, Urgent-care operators, Lenders, Urgent-care and retail-health operators, Healthcare PE associates and partners, Health-system corporate development, Investors and analysts - Tags: urgent-care, walk-in-clinic, retail-health, operating-model, dcf, urgent care, retail health, payer mix, de novo ## Overview Urgent-care clinics combine local demand, payer mix, clinical staffing, and site expansion. This model helps you see how those everyday operating decisions build into revenue, profit, and cash flow across a group of clinics. Use it for budgeting, acquisition analysis, or growth planning. It makes it easier to test what happens when visit volume, reimbursement, staffing costs, or new-clinic openings change. ## What's included - Capacity inputs: Year-1 clinics, new clinics per year, visits per clinic-day, operating days - Utilisation: Year-1 utilisation with an annual ramp and a practical ceiling - Payer mix: commercial, Medicare, Medicaid, and self-pay shares of visits - Net rates: per-visit reimbursement by payer, occ-health per clinic, ancillary per visit, rate escalation - Cost structure: providers and support per clinic, provider comp, support wage, benefits, wage growth, medical supplies, rent, malpractice, marketing, SG&A, depreciation, tax - Capital and working capital: maintenance capex, build-out cost per clinic, NWC, base-year revenue - Valuation: WACC, terminal growth, net debt, shares outstanding - Operations sheet: clinic roll-forward, utilisation ramp, visits per clinic, annual visits, provider and support headcount, visits per FTE - Revenue sheet: payer-mix patient-service revenue, occupational health, ancillary, total revenue - P&L sheet: revenue to net income with headcount-driven labour and depreciation, margins, identity check - FCF sheet: NOPAT, depreciation add-back, capex, change in NWC, unlevered FCF, discount factor, PV - Valuation sheet: sum of PV, terminal value, enterprise value, equity value, value per share, implied EV/EBITDA - Dashboard with clinics, annual visits, utilisation, revenue per clinic, net revenue per visit, EBITDA margin, EV, per share, and revenue mix - Cost structure: providers and support per clinic, provider comp, support wage, benefits, wage growth; medical supplies, rent, malpractice, marketing, SG&A, depreciation (% of revenue); tax - Capital and working capital: maintenance capex %, build-out cost per clinic, NWC % of revenue growth, base-year revenue - Clinic roll-forward (opening + new = closing) and visit-throughput build with a utilisation ramp - Visits per clinic = visits per clinic-day x operating days x utilisation; provider and support headcount per clinic - Payer-mix revenue engine: commercial / Medicare / Medicaid / self-pay shares at net rates per visit - Occupational-health book per clinic and per-visit ancillary income (imaging, labs, vaccines) - P&L through provider and support labour, medical supplies, rent, malpractice, marketing and SG&A to EBITDA - Unlevered FCF bridge and DCF to enterprise value, equity value and value per share, plus a one-page dashboard ## How the Urgent Care Financial Model Works: Visits, Payer Mix and Cash Flow This urgent care financial model projects a multi-clinic walk-in operator over seven years, linking clinic growth and visit throughput to payer-mix revenue, operating costs, unlevered free cash flow and a discounted valuation. It suits readers evaluating how budgeting, acquisition or expansion decisions translate into revenue, EBITDA and equity value across an expanding clinic estate. ### What Drives the Clinic Estate and Visit Volume The model rolls the clinic estate forward each year: opening clinics plus new greenfield openings equal closing clinics, so the de novo pipeline a retail-health roll-up depends on is explicit rather than assumed. Closing clinics then feed two builds at once — annual visits and per-clinic headcount — while the year's new openings draw growth capital through a per-clinic build-out cost. - Visit volume per clinic comes from visits per clinic-day multiplied by operating days and a utilisation factor. Utilisation begins at a Year 1 input and ramps by a fixed number of percentage points annually, capped at a practical ceiling, reflecting that new clinics season gradually and a platform rarely runs flat-out. - Closing clinics times visits per clinic gives annual visits, the model's single most important volume driver. ### Why Payer Mix Drives Revenue More Than Volume Alone The distinguishing feature of an urgent-care operator is that the same clinical visit reimburses very differently depending on whether the patient carries commercial insurance, Medicare, Medicaid or pays cash. - Patient-service revenue is therefore built payer by payer: annual visits times each payer's share times that payer's net rate per visit, escalated at a contract step-up rate. - Commercial pays most per visit and Medicaid least, so the blended net revenue per visit falls out of the mix and becomes the headline yield metric — a richer commercial share lifts revenue with no change in visit count. - An employer occupational-health book per clinic and per-visit ancillary income from imaging, labs and vaccines layer on top to reach total revenue. ### How Costs Shape the EBITDA Margin Provider and support labour are the dominant cost in a clinical business, and the model makes them headcount-driven: FTEs per clinic times wage, loaded for benefits and escalated at the wage-growth rate. The remaining lines — medical supplies, rent and occupancy, malpractice and insurance, marketing and corporate SG&A — are percentages of revenue. - Because revenue escalates through rate step-ups and the utilisation ramp while per-clinic labour grows only with headcount and wage inflation, the EBITDA margin expands modestly across the horizon. - That expansion is not automatic: once visits per FTE climbs past a productivity threshold, the model adds a PRN/float staffing line at a premium rate per excess visit, a volume-linked labour lever that partially offsets the ramp's margin lift. Depreciation, tax on positive EBIT and net income complete the P&L, with an identity check. ### From Cash Flow to Valuation and Dashboard Use Unlevered free cash flow is built from EBIT, unlevered tax and NOPAT, adding back depreciation, then deducting maintenance capex as a percentage of revenue, growth capex from the year's new clinics times build-out cost, and the change in working capital. That working-capital line is a use of cash, since payer receivables absorb funds as the book grows. - The DCF sums the present value of explicit unlevered free cash flow and the present value of a Gordon-growth terminal value to reach enterprise value, then subtracts net debt for equity value and value per share, alongside an implied EV/EBITDA. A dashboard consolidates clinics, annual visits, utilisation, revenue per clinic, net revenue per visit, revenue, EBITDA, EBITDA margin, enterprise value and value per share. - Readers can flex the de novo pipeline, the utilisation ramp, payer mix or rate escalation and watch those outputs move together. ## The payer mix sets the net revenue per visit The same clinical visit is reimbursed at very different net rates depending on payer, so the model splits annual visits across a commercial, Medicare, Medicaid, and self-pay mix and prices each at its own net rate per visit. The blended net revenue per visit falls out of the mix and is a headline yield metric an analyst can flex against the cost stack, so a richer commercial share lifts revenue with no change in volume. ## Designed for one-edit responsiveness Every input, the build pipeline, the visit throughput, the payer mix and net rates, the full cost stack, capex, working capital, and the WACC, is a named-range cell. Edit one and the operations build, revenue, P&L, free-cash-flow bridge, valuation, and dashboard all recompute. No formula rewrites are needed to test a reimbursement, utilisation, or expansion scenario. ## An unlevered DCF, not an EBITDA shortcut An urgent-care platform carries real depreciation and capex on clinic fit-out and equipment and a working-capital drag from payer receivables, so the model bridges to unlevered free cash flow and discounts it at a WACC with a Gordon-growth terminal value. Enterprise value bridges through net debt to equity value and a per-share figure, and the implied EV/EBITDA falls out as a sanity check against the retail-health range. ## Workbook structure ### Cover Workbook overview, sheet legend, units, and tab-colour key. - Title and scope framing - Sheet-by-sheet purpose summary - Units and tab-colour legend ### Assumptions Every driver in one sheet: clinics, visits, payer mix, costs, capital, valuation. - Year-1 clinics, new clinics per year, visits per clinic-day, operating days - Utilisation with an annual ramp and a practical ceiling - Commercial, Medicare, Medicaid, and self-pay shares and net rates per visit - Occ-health per clinic, ancillary per visit, rate escalation - Providers and support per clinic, comp and wage, benefits, wage growth, and the percent-of-revenue cost lines, tax - Maintenance capex, build-out cost per clinic, NWC, base-year revenue - WACC, terminal growth, net debt, shares ### Operations Clinics, visits, and staffing. - Opening plus new clinics equals closing clinics - Utilisation ramps from a Year-1 input, capped at a ceiling - Visits per clinic equal visits per clinic-day times operating days times utilisation - Annual visits equal closing clinics times visits per clinic - Provider and support headcount per clinic and total FTEs - Visits per FTE ### Revenue Payer-mix revenue. - Patient-service revenue by payer equals visits times payer share times net rate times escalation - Patient-service subtotal - Occupational health equals clinics times per-clinic times escalation - Ancillary equals visits times per-visit times escalation - Total revenue ### P&L Revenue to net income. - Total revenue from the Revenue sheet - Provider and support labour equal headcount times wage times wage growth times a benefits load - Medical supplies, rent, malpractice, marketing, and SG&A as a percent of revenue - EBITDA equals revenue less total operating costs - Depreciation, EBIT, tax on positive EBIT, net income, margins, identity check ### FCF Unlevered free cash flow bridge. - EBIT and unlevered tax from the P&L - NOPAT equals EBIT less unlevered tax - Add back depreciation - Maintenance capex on revenue and growth capex on new clinics - Change in net working capital on revenue growth - Unlevered free cash flow - Discount factor and PV of UFCF ### Valuation Discounted cash flow. - Sum of PV of explicit UFCF - Gordon-growth terminal value and its PV - Enterprise value - Less net debt to equity value - Shares outstanding and value per share - Implied EV/EBITDA ### Dashboard Headline metrics and revenue mix. - Clinics, annual visits, utilisation, revenue per clinic - Net revenue per visit, revenue, and EBITDA - EBITDA margin - Enterprise value and value per share - Revenue mix across patient service, occupational health, and ancillary ## Features - **The payer mix sets the net revenue per visit:** The same clinical visit is reimbursed at very different net rates depending on payer, so the model splits annual visits across a commercial, Medicare, Medicaid, and self-pay mix and prices each at its own net rate per visit. The blended net revenue per visit falls out of the mix and is a headline yield metric, so a richer commercial share lifts revenue with no change in volume. - **Visit throughput and the de novo ramp drive volume:** Revenue rests on a transparent volume build: visits per clinic-day times operating days times a utilisation factor gives visits per clinic, and closing clinics times visits per clinic gives annual visits. Utilisation ramps from a Year-1 input to a practical ceiling as de novo clinics season, so annual visits respond to the build pipeline and the maturation curve rather than a top-down growth rate. - **An unlevered DCF, not an EBITDA shortcut:** An urgent-care platform is fit-out- and equipment-intensive and carries a working-capital drag from payer receivables, so the model bridges EBITDA to cash through NOPAT, depreciation, maintenance and growth capex, and the change in working capital, then discounts the unlevered free-cash-flow stream at a WACC with a Gordon-growth terminal value to a defensible enterprise and equity value. - **Payer mix as the top-line driver:** The same clinical visit is reimbursed at very different net rates by commercial insurance, Medicare, Medicaid or self-pay, so the blended net revenue per visit - not the visit count alone - drives the top line. - **Throughput on a de novo pipeline:** Visits per clinic-day, operating days and a utilisation ramp (with a practical ceiling) on a clinic roll-forward set annual visits, so a de novo build and its ramp are explicit. - **Headcount-driven labour, receivables-aware cash:** Provider and support labour is headcount-driven per clinic, and working capital is a use of cash because payer receivables grow with the book - both modelled, not assumed away. ## Use cases - **Intrinsic valuation:** Set the build pipeline, visit throughput, the payer mix and net rates, the cost stack, and a WACC, and read the enterprise value, equity value, value per share, and implied EV/EBITDA. Sense-check the multiple against the range that retail-health platforms change hands at. - **Roll-up and de novo planning:** Flex new clinics per year and the build-out cost per clinic to see how the de novo pipeline consumes cash and lifts visit volume, and watch revenue per clinic and the EBITDA margin respond as the estate scales. - **Payer-mix and rate stress test:** Shift the commercial-to-Medicaid mix or cut the rate escalation to model reimbursement pressure or a managed-Medicaid-heavy market, and read the blended net revenue per visit, the EBITDA margin, and the valuation impact as the yield moves. - **Platform underwriting:** Flex the de novo pipeline, utilisation ramp, payer mix or rate escalation and watch enterprise value, the EBITDA margin and revenue per clinic move together. - **Payer-mix and rate analysis:** Shift the commercial / Medicare / Medicaid / self-pay mix or per-payer net rates and see how much the blended net revenue per visit - and the top line - moves. - **Board and IC reviews:** Hand the dashboard to a board or investment committee as a single-page view of clinics, annual visits, utilisation, net revenue per visit, EBITDA and value per share. ## Frequently asked questions ### What is an urgent-care model? An urgent-care model captures the seven-year operating economics and intrinsic value of a multi-clinic urgent-care (walk-in and immediate-care) operator. It rolls a clinic count forward, converts visits per clinic-day and a utilisation ramp into annual visits, splits those visits across a commercial, Medicare, Medicaid, and self-pay payer mix at a net rate per visit, layers occupational-health and ancillary revenue, runs the cost stack to EBITDA, and discounts an unlevered free-cash-flow stream to enterprise value, equity value, and value per share. ### Why does the payer mix matter so much? The same visit pays very differently by payer: a commercial plan reimburses far more per visit than Medicaid, with Medicare and self-pay in between. The blended net revenue per visit is therefore set by the payer mix, and a shift toward commercial or away from Medicaid can move revenue as much as a change in volume. The model carries the mix and the per-payer net rates as explicit inputs so an analyst can stress reimbursement and watch the yield and the EBITDA margin move. ### How is urgent-care revenue built? Revenue starts with volume: annual visits equal closing clinics times visits per clinic, where visits per clinic equal visits per clinic-day times operating days times a utilisation factor. Patient-service revenue is then the sum across payers of visits times each payer share times its net rate per visit, escalated at a contract step-up rate. An employer occupational-health book per clinic and per-visit ancillary income from imaging, labs, and vaccines layer on top to total revenue. ### Why an unlevered DCF instead of an EBITDA multiple? An urgent-care platform runs healthy EBITDA margins but carries real depreciation and capex on clinic fit-out and equipment, and a working-capital drag because payer receivables grow with the book, so EBITDA overstates cash. The model bridges to unlevered free cash flow, NOPAT plus depreciation, less capex, less the change in working capital, and discounts it at a WACC, then adds a Gordon-growth terminal value. The implied EV/EBITDA falls out as a sanity check rather than as the valuation input. ### Can I make it a levered or single-clinic model? The template is a single-entity unlevered DCF. For an equity-IRR view, add a de novo financing schedule and bridge to levered free cash flow; for a single clinic, set the estate to one clinic and size the visit throughput, payer mix, and headcount to that location. The net-debt line already bridges enterprise value to equity value, so a financing layer slots in cleanly. ## Related templates - [Hospital Operating Model](https://finamodel.com/templates/hospital-model) - [Dental Practice](https://finamodel.com/templates/dental-practice) - [Senior Living Facility Economics Model](https://finamodel.com/templates/senior-living-model)