Health systems play long game as populations boom

There's a neighborhood in Salt Lake City that was full of young, growing families 20 years ago. Kids needed sports medicine and pediatric services; new mothers relied on women's clinics. 

Two decades later, the families are all grown up. And Intermountain Health, based in Salt Lake City, has evolved alongside them — bolstering services like primary care and physical therapy to meet the community's changing needs. 

A proactive approach

Much of this work is anticipatory, David Dirks, Intermountain's vice president of strategy and market development, told Becker's. His team keeps a close eye on growing communities and those with shifting demographics, aiming to stay ahead of the need. 

"We usually have a pretty good idea well in advance of where we see that [population] growth and we plan for that. We do a lot of land acquisition that is forward-looking that we may not build anything on for many, many years to come," Mr. Dirks said. "But we want to be prepared for when that time comes, right? So we're not reactive, we're proactive in thinking about where we may need to provide services to our community." 

St. George, a city in the southwest corner of Utah, requires such proactivity. With an expanding economy, affordable housing, and a university and national parks nearby, the area has become a magnet for retirees and young people alike. 

For a long time, Intermountain had one acute care facility in St. George's center. Now, as the area becomes more desirable, the system is looking to add care options like community hospitals in outlying neighborhoods. 

"At a bare minimum, we try and look out at least 10 years to anticipate where those trends are," Mr. Dirks said. "And then we try to look at capital plans at least five years out." 

Clearwater, Fla.-based BayCare also keeps a pulse on its evolving populations, Todd Jones, the system's chief ambulatory services officer, told Becker's. It's not a simple task in a state with one of the highest net migration rates, and can also require up to a decade of planning. 

"We know that we're in an enviable position with the migration that we're having into the state," Mr. Jones said. "When we're looking at the growth of our services and how we meet the community's needs as a community-based health system — and the largest in West Central Florida — we have an obligation to keep an eye on what's happening." 

Building a network 

Multiple counties in BayCare's service area are among the fastest-growing in the country — including Manatee County, a hot spot for retirees in the winter. When planning services in a place like Manatee, the system doesn't look to plant one seed. It aims to spread roots. 

"Our market review when we look at going into a new county is, how do we actually cover a continuum: providers, bricks and mortar, virtual care offerings and acute care?" Mr. Jones said. "So we announced that we're building a hospital in Manatee County to help accommodate what's happening in that county. And now we're looking for two properties that are scattered throughout the county to complete that whole market of our ambulatory services as well." 

The goal is smart growth; BayCare's competitors are trying to respond at the same time, Mr. Jones noted. A two-hour drive away in Altamonte Springs, AdventHealth Florida is also monitoring and forecasting population trends, according to its president and CEO, Randy Haffner, PhD. 

"Recognizing that populations are not homogenous, we have developed predictive models by service line so that we can anticipate everything from primary care, orthopedics, and oncology needs within our community," Dr. Haffner told Becker's. "Being that many of these service lines require multiple years to implement, we forecast out five years and create layered plans to ensure that we stay in front of the growth curve." 

A potential challenge 

AdventHealth Florida also has planning models to estimate how the workforce and physician needs will grow with the population, according to Dr. Haffner. There's already a pressing shortage of healthcare workers, and as people concentrate in one place, the problem could worsen — especially when the newcomers are already retired. 

It's an issue Intermountain is also considering as it looks to AI to eliminate administrative burdens, allowing providers' time to stretch further. 

"The biggest thing that is really concerning to us is access," Mr. Dirks said. "We see it exists today and it's a coming crisis, this imbalance of supply and demand. When you look at aging populations, the demand for healthcare services is going to outstrip the supply of physicians and caregivers." 

The value of outpatient care

As communities shift, health systems must remain nimble; different areas have widely different needs and will require widely different approaches. One constant is the benefit ambulatory care offerings can have for evolving populations. 

For example, BayCare has seen an influx in the number of patients between the ages of 18 and 34. This population prioritizes convenience and tends to be more tech savvy, so the system began offering walk-in telehealth services at Publix grocery stores. Patients use the BayCareAnywhere app to schedule a visit, then conduct their visit in a private clinic room at the grocer. Physicians can instruct patients to use some devices in the room, like a thermometer or stethoscope, on their own. Any prescriptions can be sent to the Publix pharmacy. It's a "health hub," a "one-stop-shop," per Mr. Jones. 

AdventHealth Florida is moving in the opposite direction, offering nine "Well 65+" locations. These primary care offices are geared toward the specific needs of seniors, including longer appointment times that allow providers to spend more time with patients. 

In Utah, Intermountain is using the flexibility of a value-based care model to instill health in the communities it serves. 

"Whenever we look at building a new hospital, we look and say, 'What can we do with our hospital-at-home capabilities? What can we do via urgent cares that can see ED-level patients?'" Mr. Dirks said. '"What can we do to help prevent people from actually needing a hospital?'"

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