Could Dignity Health + Catholic Health Initiatives = Micro Hospital?

Bremerton has a large population of elderly, disabled, economically disadvantaged and medically fragile individuals. A targeted, viable solution to meet their healthcare needs is absolutely imperative; strategies must expand access to inpatient, outpatient, and emergency services for everyone. 

My “field of dreams” would be the development of a Harrison Community Campus, bringing together a micro-hospital, a small emergency department, a primary care clinic, and an assembly of satellite offices from multiple social service agencies. And there’s reason to believe it could happen here.

This week Dignity Health officially announced a merger with Catholic Health Initiatives (CHI), the entity that Harrison Medical Center is part of. Their new organization will be the largest non-profit hospital system in the nation, employing roughly 159,000 employees at hospitals and clinics in 20 states. Dignity Health already supports construction of micro-hospitals as a cost-effective solution for healthcare delivery in urban, suburban and rural areas. Peggy Sanborn, Vice President of strategic growth for Dignity Health, said “micro-hospitals have a shorter build time, allowing the health system to bring healthcare services to patients in the community faster.”

Micro-hospitals are independently licensed facilities with approximately 8 to 25 inpatient beds, fully-equipped emergency departments and ample ancillary services, such as pharmacy, laboratory and imaging. Micro-hospitals already exist in 19 states, including Arizona and California, and have the capability to handle acuity levels equivalent to those of any standard community hospital. The micro-hospital concept is gaining traction across the nation because construction costs are considerably lower — between $7 million and $30 million — than traditional hospital facilities, according to Advisory Board statistics. 

Micro-hospitals are best suited to handle short-stay admissions anticipated to be less than 48 hours. Costs are slightly higher than for an urgent care center, yet lower when compared to traditional hospital settings. Micro-hospitals can meet 90 percent of patients’ basic healthcare needs and tend to flourish most in markets with critical service gaps by preventing at-risk populations from falling through the cracks. Ideally, micro-hospitals should be located within 20 miles of a full-service hospital, to facilitate transfer of patients to larger institutions should higher acuity healthcare needs arise.     

An organization called Emerus is the nation’s largest proponent of micro-hospitals, with 22 fully operational and almost two dozen projects currently in development. Structures range in size from 15,000 to 50,000 square feet and function as “healthplexes,” with primary care and specialty clinics. According to Vic Schmerbeck, executive VP of business development at Emerus, the objective is to provide services “in a place where people work, live and play.” 

A community facility, including a micro-hospital, would not only benefit patients, but also providers and insurers, who are crumbling under the weight of increasing costs.  Bringing together primary care, specialty care, and social services in one place would facilitate enhanced care coordination and follow-up. A single, convenient location would lead to healthier outcomes for patients and lower hospital readmission rates, especially for “high utilizers” of emergency services.

Involvement from organizations like Kitsap Connect, the pilot program focused on uniting the “social service silos” under one umbrella, would be crucial to the success of a community campus. Currently, they are compiling data to evaluate whether this innovative, connected approach provides tangible economic savings. If statistics support their assertion, this social service infrastructure must be incorporated into the community health improvement strategy to ensure long-term gains.

Some experts are concerned smaller hospitals may hinder access for larger, underserved populations; however, being slight in scale allows for considerable flexibility, an essential attribute when serving the unique needs of diverse communities. The only drawback to this plan is that right now micro-hospitals exist only in states without certificate of need (CON) laws, and Washington State has strict CON regulations. Building a micro-hospital in Bremerton will require CON approval, an obstacle that may be challenging, yet not entirely insurmountable. 

Population health strategies, focusing on value over volume, are being touted by industry experts as the next frontier toward achieving improved health outcomes. A Harrison Community Campus is an innovative answer for delivering high quality services in cost-effective manner. Micro-hospitals are a highly successful model, delivering convenient care, closer to home, while being suitably-sized to meet the fluctuating needs of evolving communities. 

Primary care, specialty care, inpatient, and emergency services must be affordable and accessible to everyone.  With careful planning and conservative execution, construction of a community “field of dreams” is feasible and would be a worthwhile investment in our children, our neighbors, and ourselves. If we build it, they will come. 

This article was originally published by the Kitsap Sun Newspaper and can be found here:  http://www.kitsapsun.com/story/opinion/columnists/2017/12/17/could-micro-hospital-work-here/956420001/