The Affordable Care Act (ACA) will have widespread implications for the nation’s healthcare providers. An estimated 32 million newly insured people under ACA will dramatically increase demand for health services, while at the same time, baby boomers reach their peak healthcare consumption years. The effects of this “perfect storm” will be particularly profound in Florida, where the older population (age 60 and older) is growing. In 2010, 17.5% of Florida’s population was 65 or older; this age group is expected to represent 25% of Florida’s population by 2030.
In addition, with the ACA’s mandate for Accountable Care Organizations (ACOs), groups of coordinated healthcare providers will be held accountable for quality of care as well as cost. While many questions remain unanswered, what is known is that healthcare systems need to transform how they operate in this new regulatory environment in order to enhance both accessibility and affordability of care.
Much will depend on real estate. We know healthcare systems need to bring services closer to patients – this means providing patient care in convenient, ambulatory settings in locations close to where commercially insured patients live. We also know they need to reduce costs – again, real estate plays a role. Ambulatory care facilities can drive costs down by repositioning services away from larger, more costly hospital locations. In turn, healthcare systems can also dramatically increase the number of patients that they serve and spread the costs of non-commercially insured patients over a larger base.While this is merely scratching the surface, we believe healthcare systems can significantly enhance accessibility, and lower costs, by considering the following advice:
1. Increase Market Share: Expanding into new territories to access a growing population of privately insured patients is a viable strategy to increase market share and control costs. Explore new locations and strategies. Ambulatory centers focused around the healthcare needs of the community are the best delivery model for gaining market share and focusing on patient wellness.
2. Emphasize Ambulatory Settings: Buying or forming physician practices in ambulatory locations allows healthcare systems to draw referrals to support current or planned inpatient facilities. Research by The Center for Studying Health System Change indicates that providers
can increase market share by strengthening service lines and referring complex cases to flagship tertiary care hospitals. Spend the time to define the necessary components of service such as imaging labs, physical therapy and other specialized types of care. Use care extenders to enable greater practice efficiencies.
3. Study Demographics: Healthcare providers need to devote more resources to collecting and analyzing demographic data in their markets and using that knowledge to identify areas with a well-insured patient base.
4. Rethink Site Selection: Attracting healthcare users to new ambulatory care facilities will require healthcare executives to think like retailers. Urgent-care and after-hours free-standing emergency centers need to be part of the continuum of care model. Providers need to compete against CVS’ Minute Clinics and Walmart’s pilot program, The Clinic at Walmart. Sophisticated portfolio modeling tools and analytics that are routinely used by retailers are now being adapted for use by the healthcare industry.
5. Focus on Branding: As healthcare systems form partnerships with other providers, it becomes essential to inform the consumer of the partnership’s role as part of a community network of care. Branding under one network identity is an important part of the process of consumer awareness. Extending the branding through architectural features, cohesive signage and way-finding programs can be highly impactful.
6. Remember Convenience: Most healthcare consumers do not want to travel to a far-off, urban location for care. To attract new healthcare consumers, providers need to rethink the type of space where they deliver patient care, with an emphasis on centralized care in one convenient location near where commercially insured residents live. New designs that emphasize convenience, the use of care extenders and the patient experience are key.
7. Emphasize Visibility: Consider convenient access and clear visibility in choosing where to locate new ambulatory facilities. Highly visible locations on major intersections or in well-located retail centers are essential to reinforcing branding and generating drive-by and
foot traffic.
