HCA, First Choice ER Form Alliance in Texas

Hospital Corporation of America announced this week that it has formed an alliance with a Dallas-based freestanding emergency room system.

HCA North Texas Division's "Hospital and Emergency Care Alliance" with First Choice Emergency Room was touted in a joint media release by the two for-profit companies as a way "to improve patient continuity of care through multiple access points for emergency services within the Dallas/Ft. Worth area… from First Choice ER to HCA's area facilities, as well as create a joint quality assurance process and team." 

The two companies have formed a "Joint Quality Assurance" team to support coordinated transfers of patients between facilities.

The agreement aims to ensure bed availability for First Choice ER patients needing acute care services provided by nearby HCA hospitals. First Choice ER transferring patients will avoid HCA hospitals' emergency departments and will instead be directly admitted when non-emergent criteria are met. 

Thomas S. Hall, president/CEO of First Choice, said in prepared remarks that "this exclusive collaboration gives our patients direct access to HCA's 5,000 physicians and 11 local hospitals" in the North Texas region.

Adam Powell, a healthcare economist and President of Boston-based Payer+Provider Syndicate Today, said in an interview that the alliance makes sense for both companies.

"Freestanding emergency rooms appeal to consumers because they offer potentially shorter wait times and greater convenience than traditional hospital emergency rooms. However, they lack the extensive capabilities of hospitals and need to transfer a portion of their patients," Powell says.

"One issue that they confront when doing so is a lack of availability of inpatient beds. Freestanding emergency rooms compete with emergency rooms attached to hospitals for inpatient capacity. When hospitals are overcrowded, they must divert outside admissions. This alliance provides First Choice patients peace of mind that they will have access to a decent hospital bed if they need one. Furthermore, the alliance provides HCA with a pipeline of patients in legitimate need of a hospital admission. Thus, First Choice benefits by being able to improve its perceived quality, while HCA benefits from the increased volume."

First Choice ER will have access to the HCA Transfer Center, a 24/7 call center to coordinate patient transfers. The two companies said the access will facilitate physician-to-physician conversations and communication with the admitting hospital.

Tony Kong, director, Healthcare & Life Sciences for consultants West Monroe Partners, LLC, says the alliance is part of the overall trend in healthcare for hospitals to expand patient access in anticipation of the Patient protection and Affordable Care Act.

"The anticipation is that we will have more consumers with coverage come Jan. 1, 2014, which means there has to be greater access to care. That care has to come anytime of the day, when there is a need," Kong says.

"We are seeing this across multiple geographies where hospitals either open up their own emergency room center that is more designed like an urgent care clinic or they are partnering with another organization, such as HCA and First Choice."

First Choice operates 17 facilities in Dallas/Fort Worth, Houston, Austin, and Colorado Springs. The facilities are staffed by board certified emergency physicians and registered nurses, and are equipped with advanced diagnostic equipment.

HCA North Texas Division operates 10 hospitals, one children's hospital, one psychiatric hospital, 12 ambulatory surgery centers, 13 imaging centers, and two freestanding emergency rooms in the DFW area.