Anchorage residents will soon have access to a brand new type of medical service that Providence Health and Services claims will be faster, cheaper and accessible to everyone.
The hospital group this month announced the launch of its ExpressCare services, debuting with five sites across the Anchorage bowl and telemedicine services available statewide. Some of the goals, according to program managers and providers, are to create a “front door” for patients who might not otherwise have a connection to primary care and to create another venue of care for patients who may not need a higher level of acuity.
By the beginning of next year, Providence Health and Services will have five Express Care clinics: four in Anchorage and one in Eagle River. The first site, located at 1389 Huffman Park Drive in South Anchorage, opened in mid-October and has already begun seeing patients, said ExpressCare clinic manager Cindi Cieslak.
Providence Health and Services already operates ExpressCare services in Washington and Oregon, but the Anchorage program originated from a market survey Providence conducted, said Tom Yetman, the chief executive of Providence Medical Group Alaska.
“Instead of telling patients what we were going to do for them, we asked them what they wanted,” he said. “(They wanted) quick care, close to home, seven days a week.”
ExpressCare is a step down from urgent care. Urgent care clinics typically provide some level of imaging services; the ExpressCare clinics will provide basic diagnostic tests and vaccines, but will escalate services like imaging and more acute conditions to urgent care clinics, primary care or, in some cases, to the emergency room.
The broader availability, quick service and low-acuity services of an ExpressCare clinic would be best suited for low-acuity conditions, Cieslak said, such as an ear infection.
The overutilization of emergency departments — where patients with conditions that don’t require the services of an emergency room go there anyway — has been recognized as a problem across the country.
Emergency departments are some of the most expensive places to get care. Urgent care centers have proliferated in recent years nationally; between 2013 and 2018, the number of urgent care clinics has grown by more than 30 percent, from 6,100 to 8,447, according to the Urgent Care Association.
Yetman said Providence thinks of ExpressCare as not competing directly with primary care or urgent care clinics. Instead, they envision the service reaching patients who may not have necessarily had contact with the medical system before, or who may have gone directly to the emergency department before.
“It’s a very nice front door to care,” he said. “If you don’t need an ER, it’s the worst place to get care. It drives up costs for everyone … and you end up waiting a lot.”
The care is also designed to be affordable. The clinics accept all insurances, and a visit costs $149. One of the ways they keep costs down is by using advanced practice professionals and certified medical assistants, and by opening clinics in areas with less expensive real estate around the Anchorage area. The location of the clinics also better serves many patients’ needs by being closer to their homes, Yetman said.
Though the ExpressCare clinics are all in the Anchorage Bowl area, they’re actually accessible statewide — along with the clinic launches, they will see patients via telemedicine on a virtual platform through an online scheduling system. In addition to being faster and more accessible for some patients, they’re also cheaper at $49 per visit, Cieslak said.
The availability of cheaper, lower-level care is appealing for multiple partnering organizations involved with ExpressCare, too. Rhonda Prowell-Kitter, chief financial officer for the Public Education Health Trust, said the organization is excited about the availability of ExpressCare as part of a long-term initiative to reduce costs across the board in the health care industry and for its members. The trust represents school district employees from various districts around the states, including thousands in the Anchorage area.
Jill Gaskill, a family practice physician with Medical Park Family Care in Anchorage and a collaborating physician for ExpressCare, said she also thought it was a market likely not being tapped right now. Many people in Anchorage briefly or who don’t regularly go to the doctor may not have an established primary care physician, but may not need a full urgent care visit or emergency department service.
“The way I would see this is as an extension of what we are able to provide in a family care clinic,” she said. “I do think that from what Providence has talked to us about and what they’ve kind of been promoting this (is) a way to fill in the gaps. A real key component of that is that there is a real communication base. It’s on Epic (electronic medical records system), which almost every provider is able to access as well.”
The hours and accessibility are features that may help reduce emergency department use and connect people with the appropriate setting of care for their needs, she said. For example, primary care physicians are often scheduled several weeks to a month out, and urgent care clinics are not always close or open for the hours someone is looking for.
She gave the example of flu cases, which often send people to emergency departments. At the same time, she said there will likely be a learning curve for patients to figure out what kinds of problems are acceptable to be treated at a place like ExpressCare.
The clinics are connected to the larger Providence system, which allows them access to Providence’s patient health records, but the information still has to be sent to primary care providers in outside clinics.
“It really does fall on the patient to try to figure out, ‘How acute is my problem?’ They don’t really know,” Gaskill said. “I think there will be a little bit of a learning curve. They don’t necessarily know… The other way I think express care will really meet a need is it will provide a door into primary care.”
ExpressCare has a list of conditions appropriate at the clinics on its web page and is quick to escalate problems to a higher level of care if necessary, Yetman said. There is still a place for patients’ relationships with their primary care physicians, too, who may help them manage chronic conditions or more complex health problems than a smaller, quick clinic can deal with, too, Gaskill said.
“We’re approaching this a little bit of an experiment, to see what we can do to make care for patients better in Anchorage,” she said. “Nobody likes to not have any option when they’re sick. The last thing we want them to do is to go to the ER. It’s always been the last step; if you can’t get access in any of the other ways … I think what we’re doing is trying to make that ladder (toward the high end of the acuity scale) a little bit taller.”
Elizabeth Earl can be reached at [email protected]