Can Hospitals Find Salvation by Offering Primary Care in the ED?

Hospitals and health systems have been taking a hard look at how they can maintain financial stability in recent years. As you’ve read here, many are venturing into urgent care, both on and off campus. Now, some are taking another step toward becoming everyday community health providers by offering, essentially, primary care in their emergency rooms. An article in Modern Healthcare details how one of them, Carolinas Healthcare System, realized the same old way of conducting hospital business was unsustainable. The answer, they hope, would be taking a broader look at how they could bring in patients who needed help managing chronic health issues, reasoning that these are the patients turning up repeatedly in the ED anyway. Now its Anson Community Hospital bills itself as a 15-bed, 24-hour freestanding emergency facility—that partially staffs the ED with primary care physicians. Instead of trying to play gatekeeper by turning away patients with nonemergent complaints, they welcome and immediately screen them to decide if they need emergency or primary care. While the evolving experiment would be unlikely to succeed in more crowded urban and suburban marketplaces, in the rural space where Anson sits—where quality care might be inaccessible to some, especially the uninsured—it may solve both the community’s need to hang onto its only health resource and Carolina’s concerns about long-term viability.