Henry Ford Health streamlining operations with urgent care expansion

Urgent care centers have long existed as loss leaders for health systems — staffing highly-paid nurses and doctors around the clock to treat sprains and wounds is expensive. For the last decade, many have amputated those operations as a cost savings measure and instead invested higher-margin outpatient surgical centers and other specialty services.

But Henry Ford Health is bucking the trend, planning to open 15 urgent care centers across metro Detroit this year alone. The Detroit system opened the fifth of the planned centers Monday in Clinton Township alongside joint venture partner Chicago-based GoHealth.

HFH's plan is to patch holes in care across the region and build its marketing presence, said Doug Ditri, COO of the system's ambulatory operations. Customers demand convenient, high-quality care more than ever, he said.

"We're finding within our market, we're not meeting the needs of our patients where and when they need it," Ditri said. "Convenience for our patients is part of it, but it's also sort of retail product where people will see our name and where we're more visible in the market."

Urgent care use skyrocketed during the pandemic for COVID-19 in part because emergency departments were overrun with patients and urged the public to seek non-life threatening care elsewhere. In 2020, urgent care clinics saw a 58 percent increase in visits, according to research from Experity.

Henry Ford Health's nine emergency departments saw more than 422,000 visits in 2021 — or an average of more than 129 visits per department per day.

About half of those who visited an urgent care center in 2020 were new patients. The pandemic showed the industry that patients want closer and more convenient care to home, said Todd Latz, CEO of GoHealth.

All of the Henry Ford-GoHealth Urgent Care centers will use the same digital medical records system as HFH's five hospitals, further streamlining care and routing patients to follow ups with specialty HFH doctors.

"A common DMR allows us to be more connected," Latz said. "If a patient comes in with a cardiac issue, we have the ability to do an immediate consult with a cardiologist elsewhere from within Henry Ford. We can save time and money for the patient and connecting their care to follow up with the cardiologist before they leave the urgent care. They won't need to go to the ER, then go to their family doctor, then get a referral. That's the old disconnected way. We're all a unified system."

For HFH, it's about infrastructure — bringing care away from its overburdened, and expensive, emergency department and funneling new patients into HFH's specialty care system from out in the community.

Every sprain, bruise and cut doesn't require an emergency room visit, which is even more expensive to operate than an emergency center. Tying up expensive ED resources for more minor ailments is an even greater loss leader for most hospitals.

A study from the Urgent Care Association of America found that hospital ED visits were 30 percent lower in communities with access to walk-in, no-appointment medical services at urgent care or ambulatory care centers compared with communities without those services.

Also, the cost of care for the same conditions or illnesses in hospital ERs are about 10 times as much as in urgent care.

"The goal is to get patients into a lower cost of care model," Ditri said. "An urgent care can be staffed by a (physician's assistant) or a (nurse practitioner). They don't have to have a regulated set of medications available. They don't need the rooms or the gurneys. It takes an incredible amount of money to run an emergency department. We can cover a lot of illnesses, like strep throat or an ankle sprain, in a more cost effective environment."

And Henry Ford Health eliminates its operational risk from running urgent cares by handing the keys over to GoHealth, which manages more than 180 urgent care centers across the U.S. The JV partner handles the day-to-day operations of the centers while HFH is in charge of clinical care.

To improve margins, GoHealth shrunk the footprint of a typical urgent care center.

Download Modern Healthcare’s app to stay informed when industry news breaks.

GoHealth's urgent cares range from between 2,000-square-feet and 2,400-square-feet, which is less than half the size of urgent care centers a decade of more ago, said Latz.

The Henry Ford-GoHealth Urgent Care at Seven Mile and Middlebelt roads in Livonia is tight, but not cramped. And like its counterparts elsewhere, it's an open concept. Assistants and nurses staff two circular desks in the middle with four patient rooms lining the walls. A back room allows for laboratory testing, such as blood and COVID-19 testing. The center also has an X-ray machine.

"A tighter footprint allows us to go deeper into the community," Latz said. "Our centers are the size of a typical Starbucks and located in the same retail environment. They are specifically designed for our workflows so we make the experience as efficient as possible."

GoHealth's model is to create a JV with one major health system in markets and expand within that market. Partnering with more than one system would cause GoHealth to effectively compete against itself for desirable real estate and patients.

While the plan is for 15 urgent cares in 2022, both JV partners expect to continue to open new centers in the region for years to come.

"We have started with 15 for what we feel will cover our gaps," Ditri said. "But we're already talking about a second wave if these are successful. I wouldn't be surprised if we end up with more than 15 this year alone."

The JV partners are also looking to remove the burden from Henry Ford Medical Group primary care physicians by exploring moving routine vaccinations and other services to the urgent cares, Ditri said.

"We think of this as much broader than just an urgent care," Latz said. "Some patients want to engage virtually. Others want the omnichannel with in-person and virtual care. We're also seeing more demand for care in the home. There's nothing but opportunity moving forward."

But Henry Ford-Go Health will face increased competition as national healthcare firms like CVS . The nation's largest pharmacy already has more than 1,100 CVS Minute Clinics, which provide urgent care services. It also has roughly 1,000 CVS Health Hub locations that provide expanded offerings like mental health screenings and therapy.

Latz believes aligning its urgent cares care partner like HFH will set it apart from competitors.

"We don't think we're deploying the same model as the traditional urgent care," Latz said. "The demand is for a high-quality, high-experience healthcare closer to home. We don't need the same patient volume to be successful, allowing us to provide a higher level of service."

This story first appeared in our sister publication, Crain's Detroit Business.