Neighbors Health enters crowded Greeley emergency market

GREELEY – Another player is stepping into the emergency-care arena in Northern Colorado, as Houston-based Neighbors Health System prepares to open a stand-alone emergency room in Greeley next month.

The company operates 29 facilities in its home base of Texas and is expanding into Colorado in a big way, with free-standing emergency departments under construction in Aurora and Pueblo, as well as Greeley.

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It’s a trend that has seen tremendous growth in the last decade or so. A recent report from Medpac, a nonpartisan agency advising Congress on Medicare issues, showed that hospital-affiliated stand-alone facilities increased 76 percent between 2008 and 2015. Additionally, 172 independent freestanding emergency centers have been built since 2010, mainly in Texas, Arizona and Colorado.

And Greeley serves as a microcosm of that trend. Currently, Banner Health’s North Colorado Medical Center operates a traditional emergency room at its 16th Street location, while both University of Colorado Health and Banner now have free-standing emergency departments in the city. With another traditional emergency room on the way as part of UCHealth’s new hospital slated to open on Greeley’s west side in 2018, Neighbors Health will make for five emergency departments in the community.

As the only independent facility on that list, Neighbors Health believes it can find a niche.

“We need hospitals in the area for admissions of our patients and transfers to them, if the patient needs ongoing care that we can’t provide, but we don’t really view it as a competitor in the market,” said Maureen Fuhrmann, chief development officer with Neighbors. “Now, if there were four or five independent models operating, that would probably be a market we would stay away from.”

Fuhrmann said Neighbors Health provides a unique experience for patients. “What we do different from a traditional hospital (is), we have the capacity and the time to see patients, coordinate their care, give them follow-up, and that ultimately results in reducing unnecessary admissions and helps reduce health-care costs.”

Part of that experience involves less waiting. The facility will come with a full-service lab on-site to help expedite test results. “We also have immediate access to CT Scan and radiology,” Fuhrmann said. “Patients don’t have to go to another floor or (get) wheeled around the hospital. They’re right there in the department. So there are a lot of procedures we have that allow us to treat the patient more efficiently and discharge them quicker.”

Health-care officials say they are simply following the demographics, which saw Weld County’s population increase by more than 50 percent between 2000 and 2015. “Our goal is about providing access to care close to home,” said Marilyn Schock, chief operating officer of Poudre Valley Hospital in Fort Collins and Medical Center of the Rockies in Loveland. “As the population was really growing in Greeley, there was nothing on the west side of town, and that was why we decided to build our free-standing emergency department over there.”

That growth is also the impetus behind the new UCHealth hospital in Greeley, which Schock will head once it’s complete. “We have many people from Greeley proper but also from Weld County at large that utilize our services, with many of them coming to Medical Center of the Rockies,” she noted. “So [the new hospital] meets a current demand, but it’s also meeting the future demands in regards to the estimates that we’re hearing about population growth in the whole region.”

But Margo Karsten, CEO for Banner Health’s facilities in Northern Colorado, thinks the Greeley market is getting crowded. “I would say it’s highly competitive,” she said. “We’re seeing it nationally and locally. I think all health systems are trying to improve access to the community, and I believe there’s an over-saturation of free-standing emergency rooms.”

Yet the increased competition doesn’t seem to be applying the typical downward pressure on the cost of services. Just the opposite, in some cases. Federal law prohibits independent facilities such as Neighbors Health from accepting Medicare or Medicaid, which can lead to unexpectedly high bills. In fact, a recent study by the Center for Improving Value in Health Care, a nonprofit that monitors health-care costs in Colorado, found that patients at free-standing emergency departments could pay up to 10 times more for treatment than at a typical urgent-care center.

Another problem is that patients may not realize the difference between the various facilities. “Due to their stand-alone buildings and similarity to non-emergency options, it is possible for consumers to mistake an FSED for an urgent care center,” the CIVHC report states.

Karsten echoes that concern. “I worry … for the elderly in our community, it can get confusing on where to go to in that emergent situation, when you see emergency rooms all over,” she said. “We plan to do some good communication in the community on helping people understand all these different access points and making sure we keep them safe as they’re seeing all the different places to go to.”

And rather than compete for emergency-room patients, Karsten said that Banner will be taking a different approach when it comes to the Northern Colorado market. “We’re trying to keep people healthy,” she said. “We want to get people the care they need when they need it and try to avoid emergency visits.”

Neighbors Health Systems expects to open the eight- to 10- bed unit at the corner of 35th Avenue and 20th Street in Greeley by the second week of December.