What does it mean to be an urgent care center in an IDN?

JHC-July15-CVRIntegrated health systems are in a unique position to capitalize on the opportunities in the urgent care market … if they can recognize them, says Ulana Bilynsky, assistant vice president, MedStar Ambulatory Development. Bilynsky made her comments at the recent National Urgent Care Convention in Chicago, sponsored by the Urgent Care Association of America.

MedStar – which owns 10 hospitals in the DC-Baltimore area – is serious about ambulatory care, explained Bilynsky. Since 2007, the IDN has increased the number of physician office locations it owns from 36 to 155, and physical therapy sites from 31 to 48. The IDN employs about 1,500 physicians and has an insurance product for its employees.

Urgent care is a key ingredient of MedStar’s ambulatory care plan, she said. Eight years ago, the IDN didn’t have any urgent care centers. Today it has 10 MedStar PromptCare locations, with plans to open four more in the coming year. One of those centers is a freestanding building, while others are located in strip malls or retail spaces. Typically, each is between 3,500 and 4,000 square feet, with six or seven exam rooms.

“What does it mean to be an urgent care center in an IDN?” asked Bilynsky. “Sometimes it’s an obligation, and that may create challenges from an urgent care business perspective. But often, it’s about identifying opportunities, and focusing on the opportunities that come with being part of a much larger health system. Freestanding urgent care centers don’t have some of the luxuries that we as a large system can bring to the table.” Flexibility, staffing and referrals are just a few.

For example, a couple of MedStar PromptCare sites have excess space, which the IDN makes available to some of its orthopedists, cardiologists, sports medicine specialists and others whom the IDN employs. One ambulatory care center – in Federal Hills – encompasses 25,000 square feet, enough for PromptCare urgent care, a primary care practice, physical therapy, a cardiology practice, and a women’s practice, with space left over for “session time” from various specialists.

“We look for situations that make sense from a referral standpoint,” said Bilynsky. Orthopedists are happy to carry on their practice at least part-time in the PromptCare facilities, because many of the patients who visit the facilities have some kind of injury, and can be referred to the orthopedist for followup treatment. Conversely, the orthopedists and other specialists appreciate that MedStar has an urgent care center that can treat their patients when the specialists’ offices are closed.

MedStar tries to group its sites in a compact geographic area, so they can share staff and other resources when necessary, said Bilynsky. With PromptCare facilities nearby, MedStar’s primary care physicians are relieved of the pressure to maintain late-evening and weekend hours, she added.

Another advantage of being IDN-owned is the fact that MedStar’s PromptCare locations use the same electronic medical record system as its employed physician practices (both primary care and specialty), said Bilynsky. “So, when the patient comes in to PromptCare, and they happen to be a patient of one of our physicians, the doctor in the urgent care center has information about the patient in front of them.” They have the ability to “see” more than they would without that historical information.

What’s more, the PromptCare sites acquire medical supplies and equipment through the IDN’s corporate supply chain division.

Unique opportunities
“We’re in a competitive market,” said Bilynsky. That makes site selection very important.

MedStar considers several factors when selecting urgent care sites. Which competitors, if any, are in the area? What are the key demographics? Is the site a strategic fit with the IDN? Do people in the area recognize the MedStar name? If MedStar were to open a PromptCare site in that location, would it serve the needs of MedStar’s own employees who may need urgent care?

Once it selects a location for a PromptCare site, MedStar can take advantage of unique opportunities, including:

  • Sports medicine. The urgent care centers offer many opportunities for MedStar’s sports medicine primary care physicians.
  • Healthcare screenings for the community.
  • Pre-employment screening and vaccination programs for MedStar employees.
  • Occupational medicine.
  • Telemedicine. MedStar is considering giving physicians in some of the urgent care sites the opportunity to conduct virtual visits with patients.

As an integrated health system that employs many physicians, MedStar has a definite advantage over independent urgent care centers when it comes to recruiting physicians. For example, it can offer young physicians a career path. “We can offer them more flexibility to pursue things that might be of interest to them,” said Bilynsky.

“It’s important as a network to look at the things that you have that your competitors don’t, and then capitalize on them,” she said.