Urgent care centers have experienced explosive growth across the United States in recent years. This surge in urgent care facilities and patient visits has brought with it increased regulatory scrutiny. In this environment, maintaining strict compliance is more critical than ever. Below, we explore the industry’s expansion, the evolving regulatory landscape, and how automation through platforms like Credentially helps urgent care providers stay efficient and compliant.

Urgent Care: An Industry on the Rise

The urgent care sector is one of the fastest-growing segments in healthcare. As of 2023, there are over 14,000 urgent care centers in the U.S., with new centers opening at roughly a **7% annual growth rate.** Patient demand is driving this expansion, **patient volume at urgent care centers has grown 60% since 2019.** This growth reflects patients’ desire for convenient, same-day care for non-emergency issues. Urgent care clinics have proliferated from urban areas to suburbs and even rural communities, expanding access to healthcare and relieving pressure on crowded emergency departments. Industry valuations mirror this trend; analysts projected the urgent care market to exceed $26 billion by 2023, underscoring its substantial economic footprint.

This rapid expansion positions urgent care as a key healthcare access point. Clinics now handle everything from flu shots to X-rays and lab tests, often operating 7 days a week to meet demand. However, growth brings new challenges, particularly in managing regulatory compliance at scale. As urgent care organizations add more providers and locations, they must ensure every clinician is properly credentialed, licensed, and meeting standards—no small feat in a highly regulated industry.

Growth Brings Greater Scrutiny

With urgent care’s rising prominence comes heightened scrutiny from regulators and payers. Government agencies and insurance companies are keen to ensure that the booming urgent care sector adheres to healthcare laws, quality standards, and billing rules. Failing to properly credential and comply can carry severe consequences. Industry experts warn that neglecting credentialing “can lead to severe consequences, including loss of revenue, hefty fines, and even jail time,” and urgent care’s impact has brought “increased scrutiny” from both government and commercial payers. In other words, as urgent care centers multiply, there is zero tolerance for compliance lapses.

Regulations are continually evolving. For example, in the wake of the COVID-19 pandemic, many temporary healthcare waivers expired, meaning urgent care clinics must revert to or adjust to updated regulatory requirements. Keeping up with changes in credentialing criteria, insurance billing rules, OSHA and HIPAA regulations, and state healthcare laws is a growing challenge. What might have been manageable for a single clinic becomes far more complex for organizations with dozens of sites across multiple states. Payer credentialing rules often vary by state and insurer, and missing a detail can jeopardize a clinic’s ability to bill for services. A simple oversight, like allowing a provider’s license to lapse or billing under an uncredentialed provider’s name, can result in denied claims or even the loss of insurer contracts, directly impacting patient care and the bottom line.

Compliance matters more than ever in this growth era because the stakes are so high. An urgent care operator not only risks financial penalties but also reputation damage and interruption of services if found non-compliant. Ensuring every provider meets all licensing, certification, and documentation requirements at all times is now a foundational part of running an urgent care business.

Automation: Ensuring Compliance and Efficiency

To keep up with both growth and the ever-changing regulatory landscape, urgent care organizations are turning to automation. Digital credentialing platforms like Credentially help clinics manage the complex web of provider onboarding and compliance tasks with greater accuracy and speed. Automated credentialing offers a reliable, consistent process for handling everything from primary source verification to ongoing monitoring of licenses and certifications. By using software to handle repetitive checks and paperwork, clinics reduce the risk of human error and ensure nothing falls through the cracks.

How Credentially Helps Maintain Compliance:

• Real-Time License Tracking: Automation can continuously verify provider licenses and certifications. For example, software can pull data from licensing boards or the OIG exclusion database automatically, flagging any issues immediately. This means urgent care administrators are alerted of expirations or sanctions right away, ensuring no provider practices with an expired license or missing credential.
• Policy and Regulatory Updates: A digital platform is updated centrally, so any new regulatory requirements (e.g. updated state scope-of-practice laws or insurer criteria) can be quickly built into the workflow. This helps organizations keep up with ever-changing governmental and payer regulations via automation, rather than relying on each clinic manager to catch updates.
• Audit-Ready Documentation: Credentially and similar systems maintain a central source of truth for all provider documentation. Every diploma, board certification, background check, and training record is stored and easily retrievable. When regulators or payers request proof of compliance, urgent care administrators can generate reports on expiring documents, completed trainings, or immunization records in seconds. This level of organization not only ensures compliance but also reduces the administrative burden of audits and paperwork.
• Efficient Re-Credentialing: Most payers require re-credentialing of providers every 2–3 years. Automation handles this proactively by sending reminders well in advance of deadlines and even pre-populating renewal applications with stored data. This ensures no lapses in credentials that could interrupt a provider’s ability to see patients.

By streamlining compliance processes through automation, Credentially enables urgent care operators to focus on growth and patient care, rather than chasing paperwork. The platform ensures that as a business expands – hiring more clinicians and opening new sites – its compliance standards scale accordingly. In a sector where regulatory missteps can be costly, this kind of technological support is fast becoming a necessity.

Credentially’s impact is both in efficiency and peace of mind: clinics can trust that every provider on the schedule is properly vetted and cleared to work, and that they can prove it to any inspector or payer. This not only avoids penalties but also upholds the high quality of care that rapid urgent care growth demands. In short, the urgent care boom makes compliance a cornerstone of success, and automation is the smart way to achieve it.

Credentially’s solution embodies that smart approach,  keeping growing urgent care organizations compliant, efficient, and ready to serve patients without interruption.