Healthcare Company With Emergency Room and Urgent Care Model Thriving

During the coronavirus pandemic, Intuitive Health has experienced strong patient volume growth and has retained clinical staff.

A Plano, Texas-based healthcare provider that is operating an emergency room and urgent care model under one roof has been experiencing success during the coronavirus pandemic.

In 2021, Intuitive Health saw explosive growth in patient volume—patient facility usage across all locations increased by 52% over 2020. In 2020, patient volume was up 35% over the level in 2019.

Intuitive Health is also expanding its locations, with new facilities opened in 2021 in Ohio and Florida. The organization is now operating 14 facilities in Florida, Indiana, Ohio, New Mexico, and Texas. Intuitive Health plans to operate 28 facilities in 13 states by the end of 2022.

Intuitive Health's emergency room and urgent care model addresses a longstanding problem in healthcare, says CEO Thom Herrmann, MBA. "The problem is if a patient shows up in a hospital emergency department, and they only need urgent care-level services, they are going to spend $2,000 or more when it could have cost them or their payer only $200 if they went to an urgent care center. On the flip side, if a patient ends up going to an urgent care center and they are having a life-threatening emergency, they are putting their health at risk."

Intuitive Health has taken the uncertainty out of a patient's decision to seek care in an ER or an urgent care center, he says. "The uniqueness of our model is we have decided to simplify things for patients. Every one of our locations is a free-standing, 24-hour, seven-day-a-week emergency department that also treats urgent care conditions. If a patient is not sure whether they should go to an ER or an urgent care center, they can come to our facility at any time of day. They are going to be evaluated by an ER physician. We have all of the same services as a hospital emergency department; but if it turns out that the patient does not need ER care, they are going to get a much lower-cost urgent care bill."

Resource utilization determines whether a patient is charged for an ER visit or an urgent care visit, Herrmann says. "We use resource-based criteria to determine whether someone receives ER-level care or urgent care-level care. There are certain services that are only available in an emergency department such as a CT scan or a complex lab service. Depending on what our physician needs to order or do to diagnose and treat the patient determines whether a visit is going to be billed as an ER visit or an urgent care visit. Most of our patients walk out with an urgent care bill because most situations do not require a high, ER-level of care."

Intuitive Health has six facilities in the Dallas market that the organization owns and operates independent of health systems and hospitals. However, its other facilities and future facilities will be operated as joint ventures with regional health systems, he says. "When we come into a new market with a health system, each one of the locations that we open is going to be branded under the health system's brand, but we are operating that facility for our health system partner."

Drivers of patient volume growth

Pandemic-related factors have driven patient volume growth at Intuitive Health facilities over the past two years, Herrmann says. "Some of the growth is testing related—over the past twelve months, patients have been looking for COVID testing. But there is a much bigger underlying trend unrelated to COVID testing."

Since the pandemic began, patients have been trying to avoid hospital emergency rooms, he says. "In 2020, there was a lot of fear and attention focused on the chances of contracting a communicable disease such as COVID inside a hospital emergency department. Most people have an experience of going to a crowded, somewhat disorganized emergency department, and it is not a pleasant experience. It is inconvenient. There are usually a lot of sick people waiting in the lobby. Most patients have to wait a long time in the lobby. So, in 2020, patients did everything they could to try to stay away from hospital emergency departments."

Intuitive Health facilities are an attractive alternative to hospital emergency rooms, Herrmann says.

"If you walk into one of our typical centers, patients generally wait in the waiting room for less than 10 minutes before they are taken to a room. Our design is focused on rapid throughput for the patient. Our sites are also clean and sanitary. So, when patients have the opportunity to experience service in one of our facilities, they realize that we offer all of the same emergency services that they would get in a hospital emergency department. They also understand the value proposition that if they do not need ER services, they are going to get a lower-cost bill," he says.

Staff retention

During the pandemic, Intuitive Health has been able to buck the trend of clinical staff shortages. Early in the pandemic, childcare was a prime motivator for clinical staff to leave healthcare organizations, Herrmann says. "You had people who expected their kids to be in school, then the schools or their childcare center were closed. They faced dropping shifts to care for their child at home. The first step was working collaboratively with our staff to identify employees who had childcare challenges and have them change shifts with other employees who did not have those same kinds of challenges."

Intuitive Health also offered retention bonuses to encourage staff to remain with the organization, he says. "As market conditions changed and workloads changed, we introduced retention bonuses as a way to compensate employees for sticking through the challenging time of increased COVID patient volumes."

The organization also focused on safety, Herrmann says. "We made sure that clinical staff had all of the personal protective equipment that they needed, that they were working in a sanitary environment, and that we had screening protocols for patients who we thought were symptomatic or at high risk for transmission of coronavirus."

Burnout has been a top concern, he says. "We made sure staff were getting relief from long shifts. We made sure there was adequate staff support within all of our clinics—whether that was scribes or administrative support—to try to make life as easy as possible."

The multipronged effort to retain staff has been successful, Herrmann says. "All of these things in a cumulative sense allowed us to retain staff at a high rate and maintain high employee satisfaction scores."