Urgent care visits have been growing over at least the last two decades nationally.
This trend has accelerated in recent years and is now receiving national public attention. Reasons for this increasing trend are varied from greater insurance coverage from the PPACA to changing expectations of convenience and continued tightening of scheduled primary care visits availability. These and other drivers suggest urgent care growth will continue for at least the next several years.
As a result, health systems that want to influence this growing channel of primary care must embrace urgent care and incorporate it into their system.
Five tips on how to begin.
1. Understand the consumer-perceived needs
A 2015 Urgent Care Partners' survey of nearly 1,500 urgent care users showed urgent care fills basic convenience and service needs that are not met by the traditional scheduled primary care clinics, predominantly prompt care in a convenient location. While primary care clinics often claim to have immediate access for patients that "need" prompt care, the determination of "need" is done by the clinician rather than the consumer. As a result, mismatched expectations create an unmet consumer demand for a provider that can address their clinical needs on the timeframe and in the setting the consumer desires.
To begin, start by evaluating your market to see if non-traditional providers are offering services patients traditionally receive from your system or if there are concierge or urgent care centers opening. If there are on-demand type providers arising, they are serving an unmet need or working to change the populations' expectations. In either case, your health system needs to begin developing a game plan.
2. Evaluate your system's primary care channels
Primary care today is delivered through five major channels. Any urgent care planning process needs to understand where urgent care fits within the health system's primary care delivery platform. Urgent care is experiencing much faster growth than the traditional scheduled physician clinics. While in 2012 urgent care accounted for only a little more than 11% of all primary care visits, (versus 82% for traditional scheduled clinics), urgent care is growing much faster.1 Between 2015 and 2020 urgent care is projected to grow 35% more than traditional scheduled primary care clinic volumes. As a result, systems wanting to capture new patients should look to the growing channels of primary care, of which urgent care is the biggest.
Evaluating your health system's primary care channels process starts with a review of how patients can access your system when and how they want. Secret shopping, understanding what someone would do if they wanted to see a primary care provider right now, how patients who don't have a primary care provider in your system would get in, what does it cost, how much paperwork needs to be filled out, etc. can provide tremendous insight into how it feels to be an individual who wants to access care on their terms. Factoring in this approach with a traditional primary care market plan will start providing both a market and channel primary care view.
3. Build or engage the right capabilities to implement developing your urgent care division
Urgent care operations are fundamentally different from other parts of the health system. It is a highly consumer-focused, low-acuity service that demands the delivery model maintains the highest quality while rapidly serving the patients who arrive in a random pattern. As a result, health systems' track record of providing financially accretive urgent care models is poor. On the other hand, private urgent care companies often make a 15-20% margin. The solution is not to give up urgent care to others, but build the right capabilities internally to participate in this growing trend.
Envisioning primary care delivered "on-demand" and through a model with high levels of customer convenience and service is often closer to starting with a blank sheet than incrementally adjusting the current health system primary care models. To pull this off, health systems must give the space and time to a team that is not constrained by the existing processes and culture. At a minimum, this means hiring leaders who understand retail services and often means forming joint ventures or management service agreements with experts.
4. Design the urgent care model around the consumers' demands not your historical approach
Urgent care is fundamentally a retail health service. To meet the quality, service, and convenience demands of the consumers, the health system's urgent care model must be more like Starbucks than the Post Office. Starting with site selection in high-traffic retail settings, the urgent care division must rethink the provision of primary care from the consumers' point of view. Front-desk personnel should be thought of as clinical concierge rather than receptionists. Facility design should focus on rapid patient flow. Supplies and medications should focus on the top 30-40 requirements rather than all or none. Follow up and downstream coordination should be a core focus as the clinical diagnosis is completed.
Done correctly, the consumers will be highly satisfied and captured by the health system.
5. Move quickly
The market is rapidly moving. Who do you want to control this growing front door to your health system, you or a venture capital firm? Venture capital is pouring into healthcare at a rate not seen in the past two decades. Payers are also interested as a means to provide immediate primary care access without having to incur the expense of an ER visit. Moreover, the urgent care market is highly fragmented offering market space for health systems (or non-traditional competitors) to capture and influence how urgent care develops.
Unless this is an organizational priority and your health system is moving rapidly to build these models, you are going to be outmaneuvered by competitors that are not constrained by your historical models of primary care.
The next wave of urgent care growth is just emerging. Health systems that want to influence the growing number of patients using this primary care channel must understand needs not being met today, know how they are meeting those needs, create new retail-focused capabilities, and design integrated urgent care models around the consumers' demands. Those that are able to accomplish this feat will ride the growing wave and influence their populations' healthcare decisions at the first healthcare touch points.
Kate Lovrien and Luke C. Peterson are principals at Health System Advisors. They can be contacted at Kate.Lovrien@HealthSystemAdvisors.com or Luke.Peterson@HealthSystemAdvisors.com. Health System Advisors is a strategy think tank and consulting firm with a mission to advise leaders, advance organizations, and transform the healthcare industry. For more information contact HSA at 877.776.3639 or www.HealthSystemAdvisors.com.
1"Remaining Relevant by Building Primary Care Delivery Beyond Physician Employment", Becker's Hospital Review, April, 2013
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