Hospital-urgent care partnership reduces overcrowded ED

In an effort to reduce overcrowded emergency departments, many hospitals look to shift patients who don't have critical or life-threatening conditions to more appropriate care settings.

One Massachusetts hospital's recent partnership with an urgent care center shows promise that other hospitals and health systems may want to consider.

Lahey Hospital & Medical Center, a multispeciality healthcare organization based in Burlington, Mass., decided to forego the expense of creating its own urgent care facility and instead collaborated with CareWell Urgent Care. The new partnership, which launched in January, allows Lahey patients access to medical care at a lower cost and frees up the hospital's emergency care staff to focus on critically-ill patients.

Lahey has a high case-mix index, one of the highest in the state, and its emergency room has been "turned into a MASH unit," said Richard W. Nesto, M.D., executive vice president and chief medical officer of Lahey, (pictured right) in an exclusive interview with FierceHealthcare. The organization admits one-third of the patients that come to the ER.

"Our hospital is on the receiving end of very sick patients and we are busy accepting patients that need immediate attention until they are transferred. Our ER is not a place for a patient who has a medical problem that needs care for, but can be taken care of quickly and at lower expense at a CareWell Urgent Care center," he explained.

Instead, Lahey can now refer patients with urgent care needs to one of four CareWell sites within its service area, Nesto said.

CareWell has seven locations in Massachusetts and one in Rhode Island, which all treat patients with urgent needs, such as infections, fractures, allergic reactions and the flu. The centers have on-site X-ray and lab capabilities and also offer select preventive care services, including flu shots and vaccinations. If needed, CareWell can access Lahey sites that offer CT-scans, ultrasounds and MRIs.

Although the partnership is in its infancy, both organizations report promising initial results and say patients are satisfied with reduced wait times and costs. "The silver lining is that a certain number of patients who don't have a primary care physician may have their first contact with CareWell and then can continue a relationship with a Lahey provider in the future without us going into the detail and expense of extending our base," he said.

Terry Giove, vice president of operations at CareWell, (pictured left) told FierceHealthcare she expects the organization will open more urgent care centers throughout New England over the next three to five years. The centers offer patients quality healthcare and convenience as they are open 8 a.m. to 8 p.m. every day of the week.

And patients who need medical attention appreciate the convenient locations and quick access to care that urgent care offers, instead of long waits in the emergency room, according to Giove. She said most patients are in and out of the centers within 45 minutes.

Nesto said he felt the time was right for the partnership because the quality of urgent care has improved over the past 15 years and patients are more comfortable seeing different providers for care. "Urgent care is part of a system of care. It is not an isolated, island of care. Years ago, they were just islands and not connected to the patient's total health," he said.

Jack Cornwell, M.D., medical director for CareWell, (pictured right) said the key to the partnership's success is the fact that each organization refers patients to one another as appropriate. Lahey offers primary and specialty care that the urgent care centers can't provide and CareWell offers episodic care as needed. "Being able to refer a patient to a Lahey primary care provider is a huge asset," he said.