UMass Memorial reveals plans to enter urgent care market

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By Emily Micucci

(Updated Thursday at 12:40 p.m.) As a Quincy-based urgent care center business prepares to enter Worcester, UMass Memorial Health Care has announced its own plans to open multiple urgent care centers in the city and the surrounding area, beginning this year.

That’s according to an e-mail statement from Dr. Eric Dickson, CEO of the Worcester-based health care system. Dickson’s comments came in response to CareWell Urgent Care’s plans to expand into Worcester in the coming months.

“As the largest health care provider in the region, UMass Memorial understands the importance of urgent care in the spectrum of health care services (that) today’s consumers expect. We are investing in multiple urgent care locations in Worcester and the surrounding communities to provide convenient, high-quality urgent care services to our patients in Central Massachusetts. We expect several of these centers to open by year’s end,” Dickson said.

Dickson: We will collaborate with CareWell

But UMass Memorial doesn’t view CareWell strictly as a competitor; Dickson also said the health care system will collaborate with CareWell, which he said is the state’s largest single operator of urgent care services, “to identify synergies” between the organizations.

Dickson was not available for further comment before deadline Wednesday morning, and officials at CareWell declined to discuss plans to collaborate with UMass Memorial because the deal has not yet been finalized.This is not UMass Memorial’s first venture into urgent care. Leominster-based HealthAlliance Hospital has been running an urgent care center on its Burbank Campus in Fitchburg for several years. And on Jan. 5, HealthAlliance opened its first retail urgent care center on North Main Street in Leominster.

Located in a popular shopping area just off Route 2 and offering evening and weekend hours, Urgent Care Leominster is designed to give patients convenient services when immediate medical attention is required. This has created another avenue to deliver health care to the sick and injured, who often face long wait times in the emergency room, and even in the primary care doctor’s office, according to Michelle Fitzgerald, senior director of outpatient services at HealthAlliance.

(The hospital) really found a need in the community, especially for (relief in) the ER,” Fitzgerald said. “A lot of the cases that were coming there really could be served at a lesser level of care.”

Urgent care sees opportunity in points west

Fitzgerald was referring to the non-emergency ailments that people regularly seek treatment for in emergency rooms, such as sprained ankles, fractured bones, even sore throats. It’s these patients that urgent care centers —a growing segment of the Bay State provider mix—are trying to attract.

Urgent care has existed in other parts of the country, especially the south and the west, for many years.

But Massachusetts is still in the early stages of an urgent care influx. Hospitals such asHealthAlliance, owned by Worcester-based UMass Memorial Health Care, are starting to get into the urgent care business, but independently owned urgent care centers, including franchises, are building large networks that are starting to expand westward.

CareWell is on the frontlines of this migration. The Quincy-based company is expected to open two locations in Worcester soon, and is weighing additional locations in the near future, according to Dr. Jack Cornwell, regional medical director for CareWell.

CareWell has a Framingham location, as well as seven others in Massachusetts and another in Warwick, R.I. Until now, Cornwell said Greater Worcester has been minimally impacted by the growing urgent care market, according to the company’s demographic studies that determined CareWell should push into the Worcester market.

“It’s kind of wide open,” said Cornwell, who explained that urgent care became a much stronger business model just a few years ago when major Bay State insurers began allowing members to receive care from urgent care centers without referrals from primary care doctors.

The Worcester market probably won’t stay wide open for long. Fitzgerald, of HealthAlliance, said she’s expecting growing competition from other providers; CVS’ Minute Clinic recently opened two new locations in Fitchburg and Leominster, and Fitzgerald said she’s interested to see how that will affect foot traffic at HealthAlliance’s two urgent care centers. Minute Clinic offers a smaller number of services than bona fide urgent care centers can. Those sites can perform lab testing and x-rays, and treat more complex injuries and illnesses.

On that front, competing urgent care centers have yet to arrive in North Central Massachusetts, according to Fitzgerald. “But I’m sure they’re coming,” she said.

CareWell favors integration

While the arrival of new urgent care centers may indeed create competition for HealthAlliance, Cornwell said CareWell’s model is built on integration with the larger provider landscape. Because CareWell specializes in “episodic care” rather than long-term medical management of patients, Cornwell said the company is competing with emergency rooms or primary care offices, but complementing their services.

And as a former emergency room physician, Cornwell said it’s likely that Worcester-area hospitals won’t mind having CareWell as a neighbor, since it will draw some of the non-urgent cases from the city’s busy emergency rooms.

“I think after a while, (hospitals) start to see that this isn’t in competition with them,” Cornwell said.

In fact, CareWell has affiliated with Burlington-based Lahey Health, and while he declined to discuss specific plans, Cornwell said the company is open to affiliating with a Worcester-area health care provider. His comments came before UMass Memorial announced its plans for the urgent care business early Tuesday evening.

In MetroWest, new urgent care centers have cropped up in a handful of locations, including Natick and Marlborough, each home to a Doctors Express Urgent Care franchise location. Franchisee Bing Yeo agreed that urgent care centers complement other health-care providers, and don’t replace the emergency room for people with serious, and potentially life-threatening illnesses. But for those who just need fast medical attention, the advantages are clear in terms of costs, as well as convenience.

Yeo noted that emergency room copays are higher than ever, hovering around $250 on average, and with more consumers covered by cost-sharing health insurance plans, the patient could be paying even more than that for a hospital visit. Meanwhile Doctors Express charges a flat fee of $169 per visit, which includes things like x-rays and lab tests.

“I think people are becoming more and more educated on this,” Yeo said.

Image source: Freedigitalphotos.net

(Note: This story was updated to clarify that CareWell Urgent Care is the largest single operator of urgent care centers in the state. Other franchise urgent care businesses may have more locations.)