Health care providers stake out urgent care turf

PHOTO/RICK SAIA Rick Pampy, a medical assistant at Reliant Medical Group's ReadyMED site in Auburn, tends to a touch screen in the building's foyer.

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By Emily Micucci

The urgent care frenzy that has swept Eastern Massachusetts is arriving in Greater Worcester, with at least three major players set to enter the market and plans from existing providers to up their urgent care presence.

But urgent care as a service is nothing new. In other parts of the country, retail centers have become common fixtures as alternatives to primary care offices and emergency rooms for people who need care quickly for non-serious illnesses or injuries, such as lacerations and broken bones.

Locally, the retail urgent care model has been less common until recently. The service has been offered mostly by health care providers such as physician groups and hospitals. But even they have begun to branch out into the retail space as new companies specializing in urgent care have started to set up shop in Central Massachusetts and throughout the state. (In addition, CVS Health operates several MinuteClinics throughout the region — expanding beyond their traditional pharmacies — to assist patients with less-acute conditions.)

Reliant will expand as competition arrives

Reliant Medical Group is a pioneer of retail urgent care in the region. While the group medical practice has offered urgent care services to its patients at Reliant facilities on Plantation Street in Worcester for 30 years, the company launched its retail ReadyMED clinics five years ago, according to Dr. Raj Hazarika, chair of same-day services at Reliant. After it opened the first retail location in Shrewsbury, ReadyMED has added locations in Auburn and Milford and is planning two more in Worcester and Hudson. The Hudson site is scheduled to open next month, while the Worcester site, which will be ReadyMED's flagship location, is scheduled to open at the end of 2015.

Hazarika said Reliant wanted to get a running start in an area of medicine that was expected to be in high demand among today's busy consumers. Urgent care centers typically offer weekend and evening appointments for medical needs that can't wait a day, and for those who are having trouble getting appointments at busy primary-care offices for urgent medical needs. They're also a cheaper and faster alternative to your typical hospital emergency room.

“We see patients' preferences changing. Convenience is a big desire from patients' perspective at this point,” Hazarika said.

In years past, most insurance companies required referrals from primary care doctors for patients to seek treatment at urgent care centers. But realizing the cost effectiveness of urgent care treatment — many provide care for a flat fee, even if a patient requires x-rays or lab work, and it's significantly less expensive than an emergency room visit — that referral is, for the most part, no longer a requirement. So says Shaun Ginter, CEO of Quincy-based CareWell Urgent Care, the state's largest operator of urgent care centers.

“In most of the rest of the United States, referrals are not, and have not ever, been required in urgent care,” Ginter said.

New player and its partners

With the shift toward retail urgent care, Reliant's presence as a leader in Central Massachusetts may soon be challenged. For starters, CareWell will soon arrive in Worcester and plans to link up, in some form, with the region's biggest health care player: UMass Memorial Health Care.

The two organizations have not provided full details on the type of partnership they're pursuing, but UMass Memorial CEO Eric Dickson said earlier this month that the system is investing in “multiple” urgent care locations in and around Worcester, and some will open this year. His comments came as CareWell announced plans to enter the Worcester market while partnering with UMass Memorial.

Officials at UMass Memorial declined to be interviewed for this report, though spokesman Anthony Berry, in a statement, reiterated plans to collaborate with CareWell. Asked about a site on Route 20 in Northborough bearing signage with the UMass Memorial and CareWell names, Berry said it's “among the potential” UMass Memorial locations.

Ginter, of CareWell, shed some light on CareWell's Central Massachusetts strategy in a recent interview. He said CareWell will open two Worcester-area locations in August, but there's room to grow from there. The company plans to open a half-dozen under the CareWell brand this year, and possibly more in 2016. Ginter did not disclose where they'll be located or how they'll operate in conjunction with UMass Memorial. But he said working with existing providers is key to the CareWell model.

“One of CareWell's focuses is collaboration” with local hospitals, Ginter said.

CareWell, formed in 2012, has worked very closely with Burlington-based Lahey Health. CareWell acts as Lahey's exclusive urgent care provider in the North Shore area, Ginter said. Lahey proactively refers patients in need of urgent care services to CareWell, which then refers patients back to Lahey for primary and hospital care, when appropriate. This agreement, Ginter said, is conducive to Lahey's population health management strategy, designed to deliver coordinated care to the patients in its territory.

“It ensures that the patient doesn't leave the family, so to speak, and that there's continuity of care and communication,” Ginter said.

To that end, CareWell will have to work collaboratively with other providers in the Worcester area, according to Ginter. He said it's inevitable that Reliant patients, for instance, will sometimes show up at CareWell sites. To provide seamless care, he said the company will need to foster good relationships with all area providers.

Benefits of competition?

CareWell will be joined by at least two other urgent care newcomers in the near future. Doctor's Express, which has locations across the country, will be coming to Worcester to offer urgent care in partnership with the Central Massachusetts Independent Physicians Associations. That deal was announced in January, and Doctors Express is expected to open a location at 115 Stafford St. in Worcester this spring, and at least one more in the city later this year.

And Tenet Health Care, the parent of Saint Vincent Hospital in Worcester and MetroWest Medical Center in Framingham and Natick, is planning to open a site in Franklin in September under its MedPost Urgent Care brand. It's also considering opening a Marlborough site, according to Teresa Prego, a spokeswoman for Tenet's Northeast region.

Hazarika, of Reliant, said far as he's concerned, the more players, the better.

“I truly believe competition is always good for consumers, patients and, ultimately, for the sector because it forces us to get better at the services we provide,” Hazarika said.