Consultation for Setting Up a Prime Care - Research Paper Example

?Donna Purcell Order 531459 12 May Consultation for Setting Up a Prime Care/Urgent Care Facility It is my role as a consultant for an existing Prime Care Facility that is owned and operated by a major hospital entity consisting of different areas of health care. Norvant, the existing corporation owns various medical facilities across many states. Its facilities are owned by private investors and corporations for the purpose of providing health care in the local communities. It is my job to research the existing facilities and provide information on setting up a new Prime/Urgent Care Facility in a local community. It is also my job to become familiar with its structure and the steps necessary in forming a for-profit facility within a community of approximately 75,000 residents. My primary purpose is to define, develop, and to show how this facility can be set up to meet government regulations and requirements and to maximize profitability. One first needs to understand what exactly a primary care facility is and what are their functions. Primary care is a term used for health care services that play a major role in the local community. The term refers to work of health care professions who act as the first and primary point of consultation for its patients. The primary physician who comes in direct contact with the patients is usually a general practitioner or family physician. This is determined by location. In some instances the patient may opt to seek other means to self-determine the seriousness of their situation. Other health care professionals would be a pharmacist or maybe a nurse; this is more prevalent in the UK. The advantages to seeing these health care professionals are evident; they provide an immediate access and do not require an appointment. However, in some areas you would need to make an appointment to see a Nurse Practitioner. They would then make an assessment of the ailment or injury and refer the patient to a primary care physician or other care. Primary care in the existing facility involves a large range of health care. This includes all ages of patients, patients from all economic backgrounds as well as geographic origins. This could also include patients who want to maintain their own optimal health, mental health, social health, chronic physical ailments, acute chronic diseases, and including multiple chronic illnesses. Therefore, it is essential that a primary care physician possess a wide range of knowledge in many areas. The physician will also maintain continuity. This is the key to the success of a primary care facility and its staff. Many of its patients prefer to consult the same primary care doctor for routine check-ups, and many like to see the same doctor for new complaints as well. Many physicians also prefer to collaborate with other primary care providers. Therefore, continuity and collaboration are two of the primary care facilities’ characteristics. The existing primary care/urgency care facility sees all types of patients from children to old adults. It’s located in a small town of 75,000 people and the residents consist of many backgrounds. The facility is located in a median income area; therefore, the patients vary from high income, mid income and low income patients. The current primary care facility see patients with common chronic illnesses; these include hypertension, heart failure and angina, diabetes, asthma and COPD, depression and anxiety, back pain, arthritis, and thyroid dysfunction. The prime care patients also include injuries of all types, broken bones, sprains, burns, cuts, abrasions, and other injuries that need an immediate assessment. This urgent care facility as well as others owned by Norvant specializes in treating serious conditions that may or may not be life threatening. According to the National Association for Ambulatory Care, “urgent care facilities are ideal for minor injuries like broken bones, small burns, muscle sprains and ear infections.” But like any organization, they also suggest that you go to a Hospital Emergency Room for chest pains, severe injuries or any head trauma. An urgent care facility such as Novant treats non-life threatening conditions and injuries faster than an emergency room, and it will most often cost less. As an example, a woman who visits a prime care or urgent care facility for chest pains and heart palpitations was treated for a panic attack at the urgent care facility for $400. If the same woman had visited a hospital emergency room, she would have been billed $2,000 and been given many more tests. Also most urgent care facilities such as Norvants’ Prime Care facilities accept insurance and usually the same as most hospital emergency rooms. However, some urgent care facilities accept cash, and offer a discount for treatment, unlike hospital emergency room treatments. Many things must be considered when setting up a Prime Care/Urgency Care facility. In the new facility, care must be taken to properly define Primary Care. Since this is the first contact the patient will have with the trained medical physician within this facility, the physician must be trained in comprehensive first contact and continuing care of any diagnosed sign, symptom or health concerns. He must be knowledgeable in health issues relating to and not limited to biological, behavioral, or social organ systems. Primary care includes promoting health, prevention of disease, health maintenance, counseling, educating the patient, diagnosis, and treatment of chronic diseases in varying settings. Prime Care is performed and managed by a personal physician who often collaborates with other health professionals among other Prime Care locations. The professionals also utilize consultation and referral when needed. Primary Care of this facility provides patient advocacy in the health care system to deliver cost effective care by coordinating health care services. Primary care promotes effective communication with patients and encourages the patient to become active in his own health care. The operating prime care service serves as the patients’ first point of entry into the health care system. Prime care patients provide patients with ready access to their own personal physician or in some cased a back-up physician when the primary physician is not available. Prime Care facilities are organized to meet the need of patients with many differing problems. The vast majority of the problems are handled in this facility itself. The projected facility will be located in the community where the target patients reside. Therefore, this will make it very convenient for the patients to access the health care facility. It will provide a wide variety of specialty and institutional consulting and referring relationships for specific care needs. The Prime Care physicians is a generalist physician who provides defined care to the undefined patient at the first point of contact and take personal responsibility for providing that patient with care. The physician must be specifically trained to provide prime care services within this type of facility. The style of a prime care facility requires that the physician be able to provide services to a defined population of patients. He must be able to treat many different types of disease and injuries as he serves as the entry point for virtually all of the patient’s medical and health care needs. Some prime care facilities use non-primary care physicians. These physicians are not trained in the primary care specialties of family medicine, general internal medicine, or general pediatrics. These physicians, however, may focus on specific patient care needs such as prevention, health maintenance, acute care, chronic care or rehabilitation. These physicians do not offer the same services offered by the first contact and continuing care. This facility must have a trained prime care physician who delivers services most often found in other Norvant facilities. Any non-primary care physician is required to work closely in consultation will fully trained prime care physicians. The prime care system will utilize the trained prime care physician and non-prime care physicians as part of the health care team with the trained physician maintaining responsibility for the function of the team. The other providers of health care in the prime care facility would be nurse practitioners, physician assistants and some other health care provider such as nurses. These trained professionals will provide specific services geared toward the prime care/urgency care facility but always with the responsibility for the patient residing with the primary care physician. Norvant needs a new facility, you are providing consulting information on how to proceed: (1) You must abide by your state’s qualifications for opening an urgent care facility. There are different requirements in different states. In most states you must be a licensed physician to operation an immediate care facility. Corporate Practice of Medicine provides a list of the states that require this. If you are in a state that is not on the list, you don’t have to be a doctor to open a practice. However, you will need to meet other stringent requirement. These requirements range from criminal clearances to bonding and legal requirements. CEOs often open large prime care facilities without any medical background. (2) You need to research the proposed area’s population and demographics to be sure that it can support the prime care/urgent care facility. The local Census Bureau is a good starting point for this information. You can obtain documentation of figures from local zoning board reports and future projections. If the area you have chosen for your facility already has other facilities, you need to consider future population growth. In areas that do not have any present facilities, you will need at least 25,000 residents to justify the investment of money, time and resources. Our projected population is 75,000 residents. That should be a determining factor in its size and location. (3) You need to write a business plan and project a tentative budget. The plan should include an overall plan of how you will operate the facility. This will include patient number projections, services performed on site, staffing needs, and a market strategy. Include in your budget expenses for rent, utilities, furniture and equipment, supplies, salaries, insurance payments, legal fees, and maintenance. You can cut the cost of these expenses by using another one of Novant’s facilities as a Business Model. (4) You are the consultant – consider hiring an urgent care clinic manager with experience in setting up these types of facilities. This person should have the same vision that you do. This person would be experienced in everything from triage to replenishing medical supplies, servicing highly technical equipment, dealing with insurance company claims, and supervising office staff. Experienced urgent care physicians swear that an efficient care center manager can either “make or break” a facility. (5) Stay on top of the competition. Be very adamant about your research when considering an urgent care facility. Search the Internet by zip code under urgent, critical, immediate, care, emergency care. Use a phone book to look up listings. Check with local non profit organizations to obtain their regional lists of local facilities. If managed efficiently, your new facility will compete with the larger competitors. (6) Research local professionals and nonprofit organizations to help start and operating the business. Urgent Care.org. along with the National Association of Ambulatory Care can be very valuable sources of information. The Urgent Care Association of America can provide needed resources too. These organizations provide in-person classes plus budget and staffing advice. You will be invited to conferences, given updates of industry research, networking and news about new technologies. The organizations stay up to day on what’s happening in the urgent care industry, and you can greatly benefit by affiliating your new facility with any of them. (7) You will need to obtain licensing for your facility if needed. Currently the only state within the United States that requires an urgent care facility to have a license is Arizona. There are a few other states that require stringent restrictions in regard to naming and marketing your facility. You will have to comply with the laws of your state regarding licenses, permits, any sanctions by the state medical system, which may include permits to operate x-ray and other technical equipment. When it comes time to hire your staff be aware of credentials, schooling background and certifications. You want to focus on certifications in prime care/urgent care in order to maintain your facilities reputation. (8) Be sure to purchase a comprehensive insurance package to cover the needs of your urgent care center. You will need standard malpractice insurance on the facility as a whole and to cover the physicians. You will need to protect the building and its contents from any natural disaster by purchasing replacement coverage on everything. A commercial insurance broker can give you the best advice on insurance. Nonprofit resources can give great information on this subject. (9) Thinking about the building itself – find the right building and you may have to remodel to make it fit with your plan. Plan for a well-equipped triage setup, private treatment rooms, office areas for private consultations, and break room for staff. Be sure to allocate room for large pieces of equipment. A construction professional can give many tips on retrofitting equipment, and will save you time, money and nerves. Now that you have organized your business plan and have the resources to set up your urgent care facility, you can focus in more detail on your strategies for profitability. A. Ask the insurance company that is contracted with your facility if they can increase reimbursements to your facility. This gives your facility more operating capital on hand. B. Keep the staff at the minimum required to run the facility. Staff could be hired to work on call or PRN as opposed to hiring full-time staff. C. You want to make sure you are seeing enough patients within a day to maximize profitability. You can use free or low cost methods of advertising. These could consist of college campuses, public radio stations and libraries. You want to make sure the public is aware that your facility exists. Make sure all the members of your staff have business cards to distribute to friends, family and associates who ask about the facility. D. Fixing your pricing for private pay patients a small percentage higher will insure a good revenue. Monitoring this tactic will be essential; if you raise the rates to high you run the risk of losing business. It’s best to raise the rates a very small amount so that most patients can afford it. E. Offer payment plans to private pay patients. Many patients do not seek the care of prime care/urgent care facilities because they do not have the immediate money to pay for treatment. If you offer a payment plan, you can increase revenue by attracting a section of the population that would not normally use your facility. F. Use electronic charting when possible. This usually requires upfront software cost, but it reduces the overall operating costs over time. Once your facility is up and operating you want to make sure you maintain the facility to the standards of the other facilities. “When patients are sick, they want someone to hold their hand and not create fear. They just want someone to talk to, whether it is about the cleanliness of the room or a doctor’s lack of communication. The concerns may seem trivial, but they make a big impact”, says CEO Lex Reddy, owner of a chain of Prime Care facilities. Patient satisfaction surveys left in the office for the patients to fill out gives great feedback on day to day operations of the facility and alerts the staff to problems that may arise. In a study done of six Prime Care facilities in 1993 it was determined that prime care is a diverse and changing important part of America’s health care system. The study was done on facilities in Boston, Chicago, Detroit, Minneapolis, New Orleans, and Seattle. All were in larger cities and larger health care providers. All of these facilities were planned to meet the needs of the patients within the communities served. The designers rejected the old stereotypical images of medial settings, instead opting for comfortable, light, welcoming spaces that enhance staff and patient experiences. They paid careful attention to patient choice and privacy, staff interaction and abundant natural light. The design concepts used project newer trends in prime care, which include more emphasis on wellness in an efficient space. They focused on client and community orientation with an emphasis on convenience. Interest in prime care/urgency care in the United States is growing daily due to economic, social and political change. It has been proven that these small entities within our communities that provide a diversified service to its residents are very well received. It gives the patient the opportunity, when the situation occurs, to seek medical treatment within their own community. By offering a full line of medical treatments for sickness and injuries, they are able to cut costs and make these facilities both profitable and a viable solution to the rising health care needs within many local communities. Entire Websites: Cohen, Gail.”How to Open an Urgent Care Center.” Web. 12 May 2011. http://ehow.com/. Wittman, Leigh. “How to Improve Urgent Care Profitability.” Web. 12 May 2011. http://ehow.com/. Wyman, Christine Marie. “Urgent Care Practice Standards.” Web. 12 May 2011. http://ehow.com/. Damoah, Adelaide. “How to Develop and Urgent Care Clinic.” Web. 12 May 2011. http://ehow.com/. Primary Care, AAFP, Web. 12 May 2011. http://aafp.org/. Primary Care. Web. 12 May 2011. http://en.wikipedia.org/. Red, James. “What is the Difference Between an Urgent Care Facility and an Emergency Room.” Web. 12 May 2011. http://ehow.com/. Kantrowitz, Min & Assocaites, Inc., “Design Evaluation of Six Primary Care Facilities.” 1993. Web. 12 May 2011. http://healthdesign.org/. Kondilis, Karen. “Prime Healthcare Services: Cropping Out Centralization.” 01 May 2011. Web. 12 May 2011. http://inside-healthcare.com/. Read More

 

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