May 15, 2017

Hartford HealthCare begins urgent-care reset

HBJ PHOTO | Matt Pilon
HBJ PHOTO | Matt Pilon
Dr. Jeff Finkelstein, medical director of the Hartford HealthCare-GoHealth joint venture and medical director of urgent care at Hartford HealthCare, stands in the health system’s new Avon location.
HBJ PHOTO | Matt Pilon
A flat-screen TV in the Avon waiting room informs patients of check-in services and wait times.
HBJ PHOTO | Matt Pilon
Dr. Jeff Finkelstein and Kirsten Jones, Connecticut market president at GoHealth, discuss patient-facing technology in an exam room at the Avon urgent care center.

As Connecticut's urgent care market evolves and matures, one of the state's largest hospital systems is significantly expanding its footprint in the industry.

A well-lit, renovated former Rite Aid in a retail plaza along Avon's well-trafficked West Main Street marks the initial site of Hartford HealthCare's reinvented urgent care strategy.

Hartford HealthCare, one of three major health systems in the state, is spending millions of dollars to relocate most of its urgent care services from regular physicians' offices to standalone retail sites with high customer visibility.

It expects to open 15 locations by next summer, which would make it one of the state's largest urgent care providers.

Lease talks and plans are in various stages for locations in West Hartford, Glastonbury, Bristol, South Windsor and Vernon.

All will be joint ventures with GoHealth Urgent Care, a Georgia-based outpatient developer that has similar partnerships with three other health systems across the country — including New York's Northwell Health system — comprising nearly 60 urgent care locations.

"This is a moment for us to dramatically expand our presence and commitment to urgent care," said Jeffrey Flaks, Hartford HealthCare's president and chief operating officer.

The 4,500-square-foot Avon space — like those to come — has an open floor plan and focuses on customer-facing technology, which was an important factor for Hartford HealthCare in partnering with GoHealth. The company also handles leasing, build-out, and operations services. GoHealth staff will work alongside Hartford HealthCare medical providers at the centers.

Patients can make appointments and check wait times online, and the lobby has a check-in kiosk and flatscreen monitor displaying the patient queue by first name. Flatscreens also adorn the wall in each of the five exam rooms, aimed at showing patients what the doctor or nurse is writing into their medical record on a nearby computer.

The strategy, said Hartford HealthCare's Dr. Jeff Finkelstein, who is overseeing the rollout and was bustling between patients during a reporter's visit to Avon this month, is to bring more patients through the door by giving them the convenience they want. The office will be open 12 hours a day during the week and eight hours a day on weekends.

Hartford HealthCare has offered urgent care walk-in hours at primary care offices and other facilities for several decades, but that hybrid approach never quite worked.

"We couldn't quite do what we wanted to do from an office building in Wallingford or wherever," Finkelstein said. "It looked like a physician's office. It didn't scream 'open to the public.' "

Being integrated with a larger health system also has its advantages. Finkelstein said the urgent care centers will be able to secure same-day or next-day appointments with Hartford HealthCare specialists and other providers, as needed.

Urgent care staff can reach those doctors by phone, HIPAA-compliant TigerText or through Hartford HealthCare's Epic electronic medical records system.

"If I just say 'call me' I guarantee I can get a call in less than five minutes from an attending cardiologist," Finkelstein said. "That's what Hartford HealthCare can offer its patients."

Finkelstein said Hartford HealthCare considered expanding its urgent care operations on its own, but found that it would have been difficult to do without a partner — especially one that has built out so many centers already.

GoHealth took just 90 days from lease signing to open the Avon location, Finkelstein said.

"No diss on Hartford HealthCare, but we can't do that," he said. "No health system can move that fast."

Todd Latz, CEO of GoHealth, said shifting real estate trends have created an opportunity for urgent care to move into relatively small retail space.

"A lot of what historically has been retail is moving online, and we think of service as being the new retail," Latz said. "So we see the opportunity to get in. We compete with Starbucks and other retailers for high-traffic spots."

Karen Goyette, Hartford HealthCare's senior vice president for strategy and system integration, estimated that the health system serves approximately 90,000 urgent care patients per year.

She expects that number to grow over the coming months.

The Avon location, which opened May 1, had 126 patient in its first three days, which Goyette said was GoHealth's strongest opening for any single location.

Unlike some urgent care facilities, Hartford HealthCare's will accept Medicare and Medicaid insurance, as well as commercial plans, she said.

Urgent care partnerships becoming a trend

At the same time Hartford HealthCare executives were working out the details of their GoHealth partnership — which was officially announced in January — Yale New Haven Health was working on an affiliation with PhysicianOne, which was officially announced the following month.

With a dozen Connecticut locations (and potentially more to come this year), PhysicianOne is the largest urgent care player in the state.

PhysicianOne spokeswoman Andrea Tager said she could not disclose financial specifics of the Yale arrangement, but indicated that the deal is not a joint venture.

The partnership is a first for PhysicianOne, which previously had more informal relationships with various providers.

"We'll probably continue to see some growth from some of our peer organizations," Tager said. "I know the industry is really changing quite rapidly, but we feel pretty confident about where we are."

Tager noted that PhysicianOne patients can check wait times and book appointments online too, and that the company is exploring further tech upgrades.

Asked about the timing of the two announcements, Latz said it's consistent with what he has seen in GoHealth's operations in four other states.

"Greater convergence, more partnerships, more affiliations," Latz said.

He views what is happening with urgent care as similar to what happened with ambulatory surgery and diagnostic imaging partnerships.

New York's CityMD is another regional urgent care competitor in the Northeast, with nearly 70 locations. Private-equity firm Warburg Pincus bought a majority stake in CityMD last month, for an undisclosed price, according to Reuters.

While PhysicianOne is a dominant provider in Connecticut, many of its locations are outside Greater Hartford.

In the more immediate vicinity, Hartford HealthCare will compete with ProHealth Express Care, Community Health Center Inc., New England Urgent Care, Concentra Urgent Care, St. Francis FastCare and others.

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