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Health care report 2012: The doctor is in

Physician-staffed walk-in centers becoming a preferred model in midstate

This Patient First facility in Cumberland County is the Virginia-based company's third in the midstate. Its fourth is slated for the Lancaster area in early 2013. Photo/Submitted

Walk-in health centers with physicians on site are leading the charge as the business model takes hold locally.

The centers provide an alternative to the emergency room or to family practices that might not be open when needed.

Players in the region that are solely focused on this type of care include Virginia-based Patient First and West Virginia-based MedExpress. Both staff their facilities with physicians.

York County-based WellSpan Health and Lancaster County-based Lancaster General Health are in the walk-in health care game with a tiered-care model.

Some centers have physicians, and others are geared toward more minor ailments and use nurse practitioners, physicians’ assistants and similar staffers.

Lancaster General Health operates one physician-staffed Urgent Care center and four locations branded as Express clinics staffed by nurse practitioners in Chester and Lancaster counties.

It is keeping its number of Express clinics co-located with retailers the same for now but opened a second Urgent Care center at the end of May, said Susan Wynne, senior vice president of business development and ambulatory services.

The health care provider is planning to open a third center in western Chester County in 2013, she said. Its Urgent Care business has accelerated faster than anticipated, Wynne said.

Meanwhile, Lancaster General expected the Express retail model to develop more slowly based on its research — though numbers have increased — and results are tracking with what it had anticipated, she said.

The health system has received feedback that it needs to further emphasize consumer education, such as informing people about the full scope of services a nurse practitioner can perform, Wynne said.

There also are some questions about whether nurse practitioners can access medical records, which they can, she said. They also can prescribe drugs for certain diagnoses, Wynne said.

Factors helping to fuel growth for its walk-in health care business lines have included the many players in the market raising general consumer awareness of these centers as health care options, she said.

WellSpan launched its CareExpress business in the second half of last year with a standalone clinic in York Township and later with two others in York County co-located with Giant Food Stores.

The Cumberland County-based grocer has partnered with Lancaster General for some of its Express clinics.

WellSpan has a physician-staffed ReadyCare facility on East Market Street in Springettsbury Township. The two models are among options the health care provider has promoted as an alternative to emergency room visits.

When WellSpan launched its CareExpess model, it said the new retail clinics would help address increased demand for primary care in the coming years, with physician shortages and prevalence of chronic diseases contributing to the demand.

The physician assistants and nurse practitioners are medical professionals who are qualified for and can treat a certain level of conditions and illnesses, whereas physicians can do more, health system spokesman Barry Sparks said.

WellSpan is holding the line for now on opening new CareExpress locations, he said.

The business has met expectations, but volumes could have been higher if not for the mild flu season, he said. That might not be the case next year, Sparks said.

Numbers could have been affected by the other standalone walk-in centers opening in the region, he said.

The company has no plans to open new ReadyCare locations, Sparks said. It previously had two locations but now operates only the Springettsbury Township site as a consolidation of resources, he said.

Patient First opened its first two midstate locations in Dauphin and York counties and added a third in Cumberland County. Its fourth is slated for the Lancaster area in early 2013, said Dr. Pete Sowers, the firm’s CEO.

The results at the centers that already have opened are about what the health care provider had expected, and Pennsylvania will continue to play a role in its expansion plans, he said.

It entered the local market as part of its business plan of steady growth into areas contiguous to where it already operates, Sowers said.

MedExpress opened its first midstate center around early 2011 and has added five others stretching from the Chambersburg to Lancaster areas, said Dean Hatcher, senior vice president of operations for MedExpress.

The company overall is experiencing “brisk” growth, Hatcher said.

People are seeking alternatives in the health care market, and patients who lead busy lifestyles might find it difficult to see their regular physicians when necessary, he said.

“We are evaluating many markets throughout Pennsylvania and contiguous states,” Hatcher said. “And I think there will be more growth to come.”

Brent Burkey

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