Steward Health Care System has struck a deal with AFC Doctors Express, the region's largest urgent care provider, that will enable patients from Steward's community hospitals to be treated for common illnesses or injuries at nearby Doctors Express walk-in centers.
The affiliation, scheduled to be disclosed Wednesday, initially will be modest in scope. It gives Steward patients access to nine Doctors Express clinics, from Braintree to Natick to North Andover. But the arrangement will eventually be extended to cover 15 more clinics the fast-growing Doctors Express plans to open across Eastern Massachusetts.
Doctors Express physicians will have electronic access to Steward patient records and can refer them to Steward doctors or specialists for follow-up care. Steward will also assign some of its physicians to work with the 45 doctors who work at the nine walk-in centers.
Boston-based Steward owns 10 community hospitals in the region, including St. Elizabeth's Medical Center and Carney Hospital in Boston. It estimates 20 percent of visits to its emergency rooms can be handled more cheaply and easily in urgent care centers, which treat conditions such as flu and strep throat, cuts, fractures, and other non-life threatening injuries.
Because most of its health insurance contracts are risk-based, meaning Steward is given a fixed amount for patient care, the for-profit system is rewarded financially for keeping patients healthy and out of the hospital. With the Doctors Express deal, Steward will have the largest number of affiliated urgent care centers in Massachusetts. Other health care providers, including Lahey Health and Partners HealthCare, also have affiliations with walk-in medical centers.
"Our model is providing care at the right site," Steward chief executive Ralph de la Torre said in an interview. "Wherever we see the opportunity to move care to a lower-cost setting, we'll do it. We need to get some of these visits out of emergency rooms and into urgent care centers, which are far more convenient and a less stressful environment for patients."
Urgent-care clinics have been sprouting up across the country and expanding rapidly, mostly independent of traditional hospitals, said Jeff Swearingen, managing director and co-founder of Edgemont Capital, a health care investment bank in New York. More recently, he said, hospitals receiving so-called "global payments" under risk-based contracts have sought to form alliances with walk-in clinic companies to boost revenues by keeping medical expenses under budget.
"Your average emergency room bill, even for a rudimentary visit, would be as much as $2,000, whereas often the same diagnosis treated at an urgent care clinic would cost under $200," said Swearingen. "Under the risk contracts, the objective of hospitals swings from maximizing the revenue from a patient's visit to keeping the costs down."
Dave Adams, managing director of Doctors Express centers in Waltham and Burlington, said the company has contracts with most major health plans. He said the clinics will continue to be open to patients of other hospital systems, but Steward is the first to sign an affiliation deal.
"What Steward brings to the table is a community care organization that is physician-led," Adams said. "That's very consistent with our model: concierge medicine for every person."
Doctors Express, owned by for-profit American Family Care based in Birmingham, Ala., has 142 locations in 26 states. The company opened its first Boston area clinics two years ago. Last year, the company's walk-in centers in Massachusetts treated nearly 100,000 patients with an average wait time of under 15 minutes.
"We are here to treat non-life threatening conditions," Adams said. "We're here for colds, coughs, strains, sprains, fractures, lacerations, flu-like symptoms, ear infections."