Sick as a dog?

Where do you go when you just feel terrible? It’s often difficult to get an appointment to see the primary care provider (or maybe you don’t even have a PCP), so the next thought is a trip to the Emergency Room. To offer a convenient and relatively inexpensive alternative, urgent care centers operated by for-profit entities have cropped up in retail spaces throughout the country. Most hospital systems have historically viewed these urgent care centers as competitors siphoning off business, but with the advent of the ACA and the drive toward value-based care delivery, hospitals are taking a fresh look at urgent care centers as part of an integrated, consumer-driven strategy.

A Connecticut Example.

Middlesex Hospital is a 215-bed hospital with its main campus in Middletown, Connecticut. It also has major satellite facilities in Westbrook and Marlborough, each with full Emergency Departments. Combined, they see over 85,000 emergency visits each year.

With its main ED and two satellite EDs, Middlesex Hospital is well-positioned to provide services in its region. ED wait times are aggressively managed and even published live on their website (I just looked, and they vary from 0:00 at one satellite to 0:34 at the main campus). That said, there are still many occasions where an illness can be more effectively and economically treated in an urgent care setting. With this in mind, MH has added three new urgent care sites in Middletown, Madison and in Old Saybrook.


The Hospital could have partnered with existing urgent care companies, but elected instead to design, construct, and staff their own Middlesex Hospital-branded facilities. Many surveys have shown that patients prefer hospital-affiliated urgent care centers, and this often has the added benefit of cementing the patient’s loyalty to a particular hospital in areas where multiple hospital and healthcare choices exist.


Patients, insurers, and hospitals know that providing these services in a dedicated urgent care center is less expensive than doing so in an Emergency Department. It is generally cheaper for the patient, and it is definitely cheaper for the insurer. Hospitals are finding that with thoughtful design and care with regard to location, that a convenient, attractive, and professional environment can be created in a retail or business occupancy space that costs far less to construct, maintain and staff than the typical hospital Emergency Department. Being less expensive does not result in a lesser level of care, just one that is more targeted to the types of illness or injury for which urgent care is intended. By providing high quality care in an appropriate setting, it is hoped that the objectives of being value-driven and controlling costs will also be achieved while providing the patients with the access and convenience that they demand.