Integrating CCCs into the Hospital System

Abstract

LIMITED SERVICE CONVENIENCE care clinics operating in retail establishments are flourishing in numbers and growing in their impact on the way healthcare is delivered in many areas of the country. In fact, the Convenience Care Association projects that convenience care clinics will grow from just over 800 in 2007 to over 6,000 by 2012. The two articles in this issue shed light on this phenomenon from different perspectives. In Houston, Texas, we also have seen a flourishing of convenience care clinic growth between RediClinics, Take Care Clinics, and other convenience care clinic models. In fact, Memorial Hermann Healthcare System has taken a leadership position in Houston to respond to the consumer-driven expectations for such clinics and in early 2007 created a joint venture partnership with RediClinic for clinic locations throughout the Greater Houston area. Each of the 15 RediClinics is located within an HEB Food Store (a leading grocery chain throughout Texas). All RediClinics are staffed by certified nurse practitioners. Oversight is provided by primary care physicians affiliated with Memorial Hermann, who are on site 20 percent of the hours the clinic is open. In addition to the RediClinics, Memorial Hermann also operates two convenience care clinics (called NeighborCare Clinics) near two Memorial Hermann community hospital emergency rooms. The emergency department shifts non-emergent patients who are able to pay cash for their care to the store front clinics, which are also staffed with nurse practitioners from Memorial Hermann. The article entitled Jumping into the Healthcare Retail Market: Our Experience focuses on the lessons learned when the MeritCare Health System in Fargo decided to enter this market. Their decision to proceed was a defensive one: their retail partner, a locally successful grocery chain, was going to open a clinic in one of their facilities, and MeritCare didrit want one of their competitors to run it. The model they implemented basically functions as an extension of their existing MeritCare healthcare services. Possibly because of the close tie-in with the rest of MeritCare, the Fast Track clinic appears to be a bare-bones type of operation (one patient room, one nurse practitioner, one waiting chair, and no sink), accepting only one managed care insurance plan, and averaging fewer than ten patients per day. Is the Fast Track clinic meeting the needs of Merit-Care's overall strategy? The article does not make this clear. It also is beyond the scope of the article to address even larger questions pertaining to the ultimate role of these clinics in the healthcare delivery system. This is also a struggle for Memorial Hermann as we work to integrate the RediClinics into our Urgent Care strategy for the Greater Houston area. DEFENSIVE POSITION Much like MeritCare, Memorial Hermann Healthcare System was placed in a defensive position in late 2004 when we decided to partner with RediClinic. RediClinic (a privately owned convenient care company) approached Memorial Hermann in mid-2004 with a business plan and a retail partnership with HEB already in place. We knew that if we did not participate as the healthcare system partner in the RediClinic model, other local health systems probably would, since they had already confirmed their interest to partner with RediClinic. RediClinic's business plan was largely geared towards placing the clinics within a large subset of new HEB stores being built throughout the growing suburbs of Houston. Memorial Hermann Healthcare System, being the largest not-for-profit hospital system in Houston, consisting of 10 acute care hospitals and a full service Children's Hospital, found this growth strategy also complementary to our own vision for geographic growth within the Houston suburbs. It is interesting to note that Memorial Hermann does not currently have hospitals or urgent care facilities within many of the targeted RediClinic ZIP codes. …