What Are Microhospitals, Their Impact on Patient Access to Care?

What are microhospitals?

Microhospitals are small inpatient facilities that usually contain anywhere from eight to 15 beds. These small-scale facilities are typically located in two- to three-story buildings in 20,000 to 50,000 spaces, according to a report from the University of Southern California Sol Price School of Public Policy.

Microhospitals offer diagnostic services, imaging, labs, and pharmacy services. They tend to have a smaller financial footprint compared to freestanding emergency departments (EDs). Importantly, microhospitals are helping to meet the needs of healthcare consumers across the country, according to David Bradshaw, the executive vice president and chief strategy and information officer at Memorial Hermann Health System.

Memorial Hermann announced last year a partnership to integrate at least two microhospitals into its care suite.

“They do provide a needed service to the community,” Bradshaw said of the deal. “Microhospitals are a lot smaller footprint and less capital to go into a community and to serve that area.”

Microhospitals go beyond the services a freestanding ED can offer. While microhospitals can’t usually perform surgery or deliver babies (some facilities are building operating rooms and creating ancillary OBGYN partnerships), they do offer a lot of emergency services. Microhospitals also host inpatient beds, unlike urgent care centers.

These facilities are useful for patients who do not have significant health needs but will require a bed for some treatments. For example, a dehydrated patient will not need admission into a traditional ED, but she can receive fluids in a bed inside a microhospital.

Microhospitals tend to be more financially reasonable compared to other alternative healthcare delivery sites, the USC report noted.

“Micro-hospitals are priced higher than urgent care centers, but far less than a full-service hospital emergency center or inpatient facility,” the report authors wrote. “So, their prices are relatively average. They can accommodate patients suffering from diseases and conditions such as acute abdominal pain, sprained and broken bones, dehydration, heart attacks, pneumonia, seizures, minor trauma, bladder infections, lacerations, and more.”

What are the challenges associated with microhospitals?

Microhospitals bring with them some upfront cost challenges. In the long run, microhospitals do tend to have a smaller financial footprint than other alternative care delivery sites. But the cost of opening the microhospital can be crippling.

Bradshaw, the EVP from Memorial Hermann, also expressed some anticipated care coordination challenges when the Texas-based hospital system absorbed two new microhospitals. Exchanging patient data and communication between disparate providers proved a daunting challenge.

“I’m anticipating that the coordinating efforts of how we serve the community and how we make schedules available to patients and messaging to the marketplace will require us to spend some good, detailed time with each other,” Bradshaw said at the time.

Many health systems are opening their own microhospitals, which may help alleviate some of those care coordination challenges. If microhospitals use the same EHR and system regulations as associated hospitals and primary care clinics, there will be fewer data exchange and interoperability issues.

However, microhospitals that are not associated with a patient’s primary care provider may have difficulty accessing patient medical history. More interoperable systems and  health information exchange is necessarily to bridge gaps between disparate providers.

How do microhospitals impact patient access to care?

Generally, microhospitals make patient access to care much easier. As healthcare becomes more consumer-centric, these facilities are meeting patient needs for convenient and cost-effective care.

“The general thought is that consumers have higher expectations in healthcare,” Bradshaw pointed out. “We as an industry need to improve our delivery to those expectations.”

“We won’t be smart enough to have one thing that fits consumers’ primary care, urgent care, and emergent care needs,” Bradshaw added. “Therefore, our strategy is to build both off the telephone, off the digital platform, and with physical locations to be the most convenient we can to the consumer.”

Microhospitals are largely located in urban and suburban areas because of this promise for convenience, the USC report stated.

Some experts argue that microhospitals are not a good fit for filling patient care access gaps in rural areas, the report authors noted. Experts say microhospitals are too large and complex to fulfill needs in those regions. Urgent care centers and standalone EDs are supposedly filling gaps where applicable.

However, separate market reports suggest the contrary, that microhospitals are indeed a good fit in rural regions.

“Micro-hospitals can bridge the gap in care delivery and quality of healthcare in underdeveloped areas. Due to its economic nature, intimate delivery model, micro-hospitals are ideal in rural areas,” said one report from Future Marketing Insights.

Rural areas do not have the human or financial capital to open several fully-staffed emergency departments. However, with only one ED per couple hundred miles, this makes emergency care access difficult for patients.

Freestanding EDs and urgent care centers can fill in some gaps, but the microhospital gives patients the option of receiving higher tier medical care without a major financial cost to themselves or healthcare providers, some experts have argued.

Will microhospital use spread across the industry?

Microhospitals represent an extremely new development in the healthcare industry, which makes it difficult to definitively predict how they will fare in the future. However, market reports say that the increasingly consumer-centric nature of healthcare makes the time ripe for microhospitals.

“Rising health care demand due to the need for more intensive service offerings locally that cannot be provided by traditional hospitals,” the Future Marketing Insights report says.

“Growing technology along with increasing expectation of patients on healthcare system becomes a significant threat to large-scale hospitals and give the opportunity to micro-hospitals. All these factors are fueling the growth of the micro-hospital market. Micro-hospitals are shifting the healthcare landscape, as they become an integral component of health care system.”

Bradshaw and his team at Memorial Hermann were also gearing up for an increased emphasis on microhospitals. The health system joined forces with two microhospitals because it wanted to meet consumer needs and help patients access care easily. There is future opportunity in that, and Bradshaw planned to keep capitalizing on that.

“As part of our partnership, we are diligently mapping out the next several locations which may even start to expand beyond the Houston [Metropolitan Statistical Area] into the neighboring towns,” Bradshaw concluded. “We have discussions going on with small cities that trade off of the Houston MSA.”

Consumerism in healthcare is likely not going away. So long as meeting patient needs is a healthcare imperative, medical professionals will work to meet some of those needs. Installing microhospitals helps patients conveniently access care at a lower cost than the ED, making them a viable option for future patient care access.