Tackling financial hurdles
to population health
Another strategy some systems have used to provide an array
of health services within the communities they serve is with
the concept of medical plazas.
Though the definition may vary throughout the industry, for Novant Health—a nonprofit integrated healthcare
system serving 4 million patients annually throughout
Virginia, North Carolina, South Carolina, and Georgia—
a medical plaza can be any collection of services that are
provided in a patient-centric and convenient manner in a
For the $3.8 billion system, these collections often co-locate a small (30–50 bed) acute care hospital with a variety
of ambulatory services such as primary care and specialty
offices, imaging, labs, and more, typically not far from existing shopping areas or greenways.
For example, Novant Health’s Clemmons Medical Center,
its 13th medical center, opened in April 2013 as a two-story,
35,000-square-foot facility offering emergency, imaging, laboratory, and surgery services. In December 2014, Novant added
a primary and specialty care medical office building to the campus, and further developments are underway.
“The real key is moving away from the concept of a big
downtown megahospital into integrated healthcare delivery
centers,” says Stephen Motew, MD, senior vice president
for physician services for Novant Health’s greater Winston-Salem area, and a practicing vascular surgeon.
“The importance of this is not only patient centricity and
ease of access, but it also allows us to offer lower-cost venues
of care,” he says. “When we set up things inside hospitals,
they tend to be more expensive, and we are really trying
to touch on all aspects of patient-centric thinking, which
20 HealthLeaders n July/August 2016
low-acuity, acute medical needs, typically with a staff of
Now that major retailers, including Walgreens healthcare
clinics, are expanding services to help consumers manage
chronic conditions, healthcare leaders must reassess what
it means for their system to offer the right care at the right
place at the right time.
For Henry Ford, that’s somewhat a work in progress. “Clearly, we’re working on refining the model and
understanding patients’ needs a little bit better. Our plan
is to actually produce more of these QuickCare Clinics, as
we understand the appropriate locations to place them,”
Though careful not to overgeneralize, he notes that young
professionals represent the main demographic drawn to the
downtown QuickCare. And while these millennials are less
interested in having a relationship with a primary care physician, the system has learned, they are also interested in a place
to get care quickly and conveniently near home or work,
which the QuickCare site is for many of them.
As a result, staff at the clinic don’t push patients without
a primary care physician to get one. “That’s one of the things
we found that’s a little bit different for us,” Szilagyi says.
“With a strong brand name like Henry Ford, people don’t
think of us as a small retail clinic. So what we’re doing is add-
ing PCP services to the site.”
Although it can be difficult to achieve direct ROI on PCPs
in a retail setting, the same can be true of primary care in
general, he says, referring back to Henry Ford’s deep invest-
ment in value-based care. “In risk contracts, we’re taking care
of the whole patient.”
No model can be one-size-fits-all, Szilagyi says. “To be able
to offer a variety of access points in a variety of ways is a key
initiative for us.”
SOURCE: HealthLeaders Media Intelligence Report, The Outpatient Opportunity: Expanding Access, Relationships, and Revenue, December 2015; http://bit.ly/29lsO0K.
Which area of ambulatory/outpatient care do you expect to be delivering your organization the greatest financial contribution
three years from now?
AMBULATORY/OUTPATIENT CARE AREAS AND FINANCIAL CONTRIBUTIONS