One of the most common issues facing any hospital system operator of urgent care centers is how much of the hospital-oriented compliance, regulatory, and accreditation burdens should apply to their urgent care centers. It is certainly one area that private operators have streamlined, thus making them far more nimble competitors. In many cases, hospital urgent care operators have limited choices because of how they are credentialed with Medicare. But what about centers under different tax IDs, part of joint ventures, or part of affiliated medical groups.
Each year we typically use the discussion topics from our strategy symposium as a jumping-off point for this forecast issue. It turns out this approach tends to be fairly reliable and predictive in terms of the trends to expect, not only in the coming year but for two or three years.
But this year seems to be packed with significant subjects to highlight. Among them are the CVS-Aetna merger; Optum’s acquisition of Davita’s medical group; the Amazon-JPMorgan-Berkshire Hathaway announcement; and a few other topics that seemed to be hot discussion points throughout the meeting.
If you are reading this article you are probably an active participant in the on-demand healthcare industry. You probably also think 2017 turned out to be a ho-hum year: no blockbuster urgent care acquisitions like MedExpress; no major hiccups in urgent care patient volume or deal flow; just another year of moderate growth and stability in an industry that seems to be meeting the day-to-day healthcare needs of consumers.
There are a wide range of opinions on whether a hospital-owned urgent care should be profitable. And over the past year it seems we are asked this question with greater and greater frequency. To be honest, the answer to the question is becoming a little less fuzzy. In fact, within five years there will be no debate. The answer will be a definitive “yes.”
Late last month the Wall Street Journal broke the news that CVS and Aetna were in merger talks. The quick take away by many who were quoted on the subject was that this deal is all about Amazon. In other words, CVS was expanding its reach into traditional healthcare not only because more people are ordering health and beauty products online rather than making a trip to the local drug store, but also because Amazon is getting licensed in several states to begin selling prescription drugs.
While researching this article, I came across the following quotes: one from a doctor and one from a patient:
From the doctor: “The inability to control the way we practice medicine and deliver care to patients is the reason that physicians are leaving medicine in record numbers. I can tell you that on an ordinary working day, if I didn’t have a single patient to see, I would still be busy for eight or nine hours doing nothing but paperwork and phone calls that are directly related to managed-care issues.”
From the patient: “I doubt that a single doctor I have seen over the last 10 years would know me if he or she fell over me on the street, including my current ‘primary care physician’ whom I have probably seen six or seven times over the past two years. The feeling I get is that I am just another widget coming down the medical care assembly line.”
It seems like every year for the past five years, those of us watching the telemedicine industry say it’s about to take off. Indeed, we continue to see glimpses of momentum. On the technology front prices have come down and quality continues to improve. Thousands of physicians now work as independent contractors from their homes, providing care to patients hundreds or thousands of miles away. The potential mass market of electronic encounters for acute episodic illnesses, home-based care, behavioral health and disease management is almost impossible to ignore.