Hos­pi­tals go dif­fer­ent ways on ur­gent care

Modern Healthcare - - NEWS - By Steven Ross John­son

Hos­pi­tals and health sys­tems are tak­ing dif­fer­ent roads on how to pro­vide ur­gent care, with some choos­ing to part­ner with ur­gent-care cen­ter op­er­a­tors and oth­ers build­ing their own. They see ur­gent care as a way to pro­vide ac­cess to pa­tients at lower cost than in their emer­gency depart­ment.

Hos­pi­tals in­creas­ingly have shifted away from see­ing ur­gent-care cen­ters as com­peti­tors to see­ing them as strate­gic part­ners in im­prov­ing pa­tient out­comes and sat­is­fac­tion and re­duc­ing costs, ex­perts say.

Steve Sel­lars, CEO of Ba­ton Rouge, La.-based Pre­mier Health Ur­gent Care, said his com­pany has 50-50 joint ven­ture deals with five health sys­tems to op­er­ate its 30 cen­ters in Louisiana. That ar­range­ment, he said, has been ben­e­fi­cial be­cause it has al­lowed his com­pany and the health sys­tems to share startup and op­er­a­tional costs. The cen­ters also give the hos­pi­tals ac­cess to a large vol­ume of po­ten­tial new pa­tients. Pre­mier’s cen­ters have 325,000 pa­tient vis­its a year, he said.

“In our part­ner­ship with a health sys­tem, we’re there when a pri­ma­rycare physi­cian isn’t avail­able,” he said.

Other health sys­tems have de­vel­oped their own ur­gent-care cen­ters as part of their in­te­grated de­liv­ery net­work. MedS­tar Health, a 10-hos­pi­tal sys­tem based in Mary­land, op­er­ates an ur­gent-care net­work called MedS­tar Promp­tCare, with 11 lo­ca­tions through­out Mary­land and Wash­ing­ton. “We’re the front door to MedS­tar,” said Ulana Bi­lyn­sky, MedS­tar’s as­sis­tant vice pres­i­dent of am­bu­la­tory ser­vices.

When a health sys­tem runs its own ur­gent-care cen­ter, the cen­ter’s role in re­la­tion­ship to the health sys­tem is bet­ter de­fined than if pa­tients use free­stand­ing ur­gent-care cen­ters, Bi­lyn­sky said. Promp­tCare serves as a way to help MedS­tar re­duce its rate of hos­pi­tal read­mis­sions by of­fer­ing out­pa­tient care to pa­tients who were re­cently dis­charged from the hos­pi­tal and who may ex­pe­ri­ence health is­sues that aren’t se­ri­ous enough to war­rant a visit to the emer­gency depart­ment or hos­pi­tal read­mis­sion. In ad­di­tion, Promp­tCare helps gen­er­ate re­fer­rals for MedS­tar if pa­tients who visit the ur­gent-care cen­ter are in need of ad­di­tional ser­vices.

The num­ber of ur­gent-care cen­ters has in­creased steadily over the past sev­eral years, from 8,000 fa­cil­i­ties in 2008 to more than 9,300 cur­rently. The cen­ters see be­tween 71 mil­lion and 160 mil­lion pa­tients an­nu­ally, ac­cord­ing to the Ur­gent Care As­so­ci­a­tion of Amer­ica.

Ur­gent-care cen­ters dif­fer from re­tail clin­ics in that they pro­vide a more in­ten­sive level of ser­vices for more se­ri­ous con­di­tions. They also have staff physi­cians who can treat most con­di­tions that are not life-threat­en­ing.

Hos­pi­tals see ur­gent care as a way to di­vert pa­tients from over­crowded and costly emer­gency de­part­ments, and that’s par­tic­u­larly at­trac­tive if they are par­tic­i­pat­ing in cap­i­tated or val­ue­based pay­ment ar­range­ments where they get dinged for costly and un­nec­es­sary ED vis­its or hos­pi­tal­iza­tions.

Many ex­perts see ur­gent-care cen­ters as a way to make care more quickly ac­ces­si­ble to pa­tients and boost cus­tomer sat­is­fac­tion. “Ur­gent-care cen­ters are able to pro­vide that con­ve­nience that pa­tients are look­ing for,” said Sel­lars, pres­i­dent-elect of the ur­gent-care as­so­ci­a­tion.

Dr. Ed Kim­lin, med­i­cal direc­tor of

MedS­tar Promp­tCare ur­gent-care

cen­ters, fits a pa­tient with an arm sling.

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