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Think Small: Making the Case for Micro-Hospitals

Source: Healthcare DIVE

Microhospitals seem to be gaining a foothold. They have been springing up as of late in multiple states, including Texas, Colorado, Nevada, and Arizona. Dignity Health, a health system with facilities in Nevada, Arizona, and California, is also considering the possibility of testing the model in California, Kaiser Health News reports.

Richard Bonnin, Director of Communications at Emerus, says Emerus is the nation’s first and largest operator of microhospitals, which are also known as community hospitals.

“Open 24/7, the micro-hospitals Emerus designs and builds are small-scale, fully licensed inpatient facilities ranging from 15,000 to 50,000 square feet,” Bonnin says. “They house between eight and 10 inpatient beds for observation and short-stay use, a similar number of emergency treatment and triage rooms, along with primary and specialty care physicians, and other outpatient clinical services co-located in the same building as the micro-hospital.”

According to the Advisory Board, most microhospitals are equipped with inpatient beds, emergency departments, pharmacies, laboratories, and imaging services. Some also offer ancillary services, which may include primary care, dietary services, labor and delivery, pediatric care and/or outpatient surgery.

The case for microhospitals

Microhositals are operating in urban and suburban areas where there are not enough hospitals to go meet the demand. Health systems are using microhospitals to establish themselves in desirable markets that do not have enough demand for full-size hospitals.

They appear to be filling a niche that is not covered by urgent care centers or freestanding emergency departments, neither of which offers inpatient facilities.

Patient costs for a microhospital visit are higher than those at urgent care centers, but lower than traditional hospital costs.

The microhospital movement seems to be consistent with the healthcare industry’s trend of moving toward population health For example, Denver-based SCL Health has already opened two microhospitals and has two more in the works.

A spokesperson for SCL told KHN its microhospitals are helping them “deliver hospital services closer to home, and in a way that is more appropriately sized for the population compared to larger, more complex facilities.”

“People are looking for closer, more intimate options for health care,” Bonnin says. “Traditional hospitals that do not provide services in the setting consumers want will be at a disadvantage.”

Could microhospitals fill the void in rural areas?

Priya Bathija, senior associate director for policy development at the American Hospital Association (AHA), told KHN the AHA believes microhospitals would a good healthcare delivery model for people in underserved areas.

“Right now they seem to be popping up in large urban and suburban metro areas,” Bathija said. “We really think they have the potential to help in vulnerable communities that have a lack of access.”

Michael Slubowski, president and CEO of SCL Health, disagrees. “Microhospitals like this are more suited for large urban and suburban metro areas,” Slubowski told Hospital & Health Networks. “This model would probably be too large and complex for a rural market.”

The Advisory board recommends microhospitals be located “within 18-20 miles of a full-service hospital to ensure a seamless transfer process for higher-acuity needs to a larger facility.”