Centura Health to open hybrid ER/urgent-care centers

Sun Nov 29 22:40:07 PST 2015

November 11, 2015

Centura Health to open hybrid ER/urgent-care centers

Modern Healthcare

By Adam Rubenfire

Like many health systems, Englewood, Colo.-based Centura Health is turning
to retail-oriented healthcare to provide more convenient, accessible care
options to its customers. Its newest offering, a free-standing hybrid
urgent-care/emergency department, may help resolve the uncertainty and cost
concerns patients face when deciding whether to go to an ED or to seek
urgent care.

Over the next eight months, the 16-hospital system will open four
freestanding centers that offer both emergency care and urgent care 24 hours
a day, with an emphasis on providing the latter, lower-cost option when
possible. Centura serves patients across Colorado and western Kansas, and is
jointly sponsored by Englewood-based Catholic Health Initiatives and
Adventist Health System, based in Altamonte Springs, Fla.

Centura is developing the centers in a joint venture with The Larkin Group,
a freestanding ED operator based in Texas that will manage the centers. This
is the first non-hospital-based project to emerge from the joint venture,
which was formed in June.

The first two hybrid centers will open in the Denver suburbs of Arvada and
Golden. The model aims to ensure that patients won't use a high-cost ED for
non-emergent needs, but also that they won't seek urgent care for injuries
that are too serious for those physicians to handle.

"If you pick the wrong (care) choice, you could have (adverse) outcomes in
either direction," said Dr. Kelly Larkin, CEO of The Larkin Group. "We love
that we can take that decision away from the consumer and they can come in
with the knowledge they'll be in the right place, and professionals will be
in the right place to make that (decision) for them."

A majority of patients will be classified as needing urgent care, Larkin
said, but emergency services, including X-ray machines, CT scanners,
ultrasound, EKG and laboratory tests will be available for more serious
needs. Clinical decision trees will help physicians decide whether a patient
should be treated with emergency or urgent care.

For now, the centers will be staffed by emergency medicine physicians from
the same group that staffs Centura's hospital-based EDs, although Larkin
said emergency nurse practitioners or physician assistants could be added in
the future if the centers experience high volumes. Many U.S. urgent-care
centers are staffed by family physicians, with some employing emergency
doctors as well.

Centura's integrated model also makes billing easier for patients in an
industry that has been historically charged with duping patients.
Urgent-care centers and freestanding EDs have been accused by patients of
being unclear about which insurers they accept and the cost of their
services. The new Centura centers should be able to avoid those issues
because their services fall under the same insurance contracts that patients
use throughout the rest of the Centura system, said Pam Nicholson, Centura's
senior vice president for strategy.

Centura said the centers will charge emergency care patients for the
controversial facility fees that are often tacked on to patient bills in
hospital-based and even freestanding EDs, but at a lower cost than a
hospital-based ED. As a non-hospital-based facility, the centers won't
assess a facility fee to the CMS.

Health systems across the U.S. have looked to retail clinics and
freestanding ambulatory facilities as ways to introduce their other
services. Unlike independent facilities, the Centura hybrid model can
connect patients to primary-care physicians or specialists within the
Centura network, Nicholson said.

That is precisely the goal of such system-affiliated freestanding EDs and
urgent-care centers, said Alan Ayers, vice president of strategic
development at Practice Velocity an urgent-care software and billing
company. Health systems' motivation is not to gain market share or to close
access gaps with such centers, but rather, to capture those patients who can
provide downstream revenue in other services, like primary care or
specialist referrals, he said.

"What we've found by and large . is that they're not really needing (these
facilities)," Ayers, a board member at the Urgent Care Association of
America, said. "They're going into affluent suburban communities where
hospitals are and they're not going into rural areas."

Jeff Wells
Deputy Editor, CAL/AAEM News Service

Brian Potts MD, MBA
Managing Editor, CAL/AAEM News Service

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