NextCare Urgent Care: John Julian, Chief Executive Officer

by HCE Exchange on May 5, 2011

Seventeen years in business have brought NextCare Urgent Care from a single facility opened in Arizona in 1993 to being one of the largest, privately held urgent care companies with sixty-two clinics operating in seven states; Arizona, Colorado, Texas, Georgia, Ohio, Virginia and North Carolina. NextCare clinics are generally located in retail settings and designed with a non-institutional look in mind. Wood flooring and soft colors fit the retail atmosphere. They are often located just outside of a shopping center or grocery store. The typical clinic has 4,000 square feet and 6-8 exam rooms. They are situated close to where people live and work.

“We occupy the space in between the primary care physician and the emergency department, says John Julian, CEO. “As payers continue to find ways to have more cost effective care for their members, we have a unique opportunity to be in that mid-ground where folks don’t necessarily have an emergency condition and they could be served in an urgent care setting quickly, conveniently, cost effectively and urgently. I feel that this is truly going to be an excellent space to be in for the future.”

A New Dimension of Healthcare

Studies suggest that anywhere from 20 to 40 percent of emergency room visits are not for emergency conditions. As a relatively new portion of the healthcare industry, urgent care has seen rather fragmented growth. “There are a lot of mom and pop physician offices that have dabbled in urgent care,” says Julian. “I think we’ll see some consolidation over the next few years.”

NextCare is always looking for expansion opportunities and they are willing to partner with existing systems and hospitals. “We are certainly looking for a hospital system that understands the value of urgent care,” he says. “One that understands that if they want to have better relationships with the payers, they need to focus on how they can provide cost effective care for their patients. The consumer is always looking for more cost effective and convenient ways to deal with healthcare needs.”

The Technology Picture in Urgent Care

“We feel that we are the very leader in technology,” says Julian. They have the capability to register patients online. A person can wait for a room to be available at their own home or office. Data for the electronic medical record is captured in advance. “We have a completely paperless environment. Patients can come in and input their data either with one of our representatives or by themselves at a kiosk. That information is loaded into our electronic medical record that the physician utilizes to document everything involved with a patient.”

Patients are generally sent home with a complete medical record. “We really want to make sure that not only is the patient care second to none, we want to make sure that the patient experience, when they come in the door to when they leave, is certainly much more convenient than going to an emergency room and waiting for hours on end.”

Keeping the Care Local

Though they are a large company with clinics in several states, the emphasis for each clinic remains the 5-10 miles surrounding that clinic. “We’re very careful not to think that just by developing a national brand, and some partnerships on a national level, that it is going to drive into the little towns and cities across the country. It really has to be a local market focus where you have a good quality physician caring for those people and they rely on him or her and come back over and over again,” says Julian.

People may try out urgent care for various reasons. Sometimes it’s simply because they have no insurance and when push comes to shove, the urgent care clinic is an easy and affordable way to be seen for a condition that may have been put off due to lack of insurance.

At the same time, urgent care clinics bring value to the delivery of healthcare in terms of the ability to save money. In spite of the economy, or perhaps because of it, urgent care business continues to grow. “The cost effectiveness of urgent care versus an emergency dept is indisputable,” says Julian. “Emergency departments have their place. If somebody is having a cardiac event or some significant trauma, they need to go to the emergency room. But urgent care facilities can handle scrapes and sprains and light fractures and UTIs and strep and colds and flu; those things not requiring emergency care.”

The Future of Urgent Care

“Urgent care is a key piece in healthcare delivery in this country. We’re not in competition with the primary care physicians; we’re here to support them. We’re not in competition with the emergency care departments; we’re here to support them. There’s a shortage of primary care physicians in this country and, in general, ERs are expensive and crowded,” says Julian. “Urgent care is only going to grow over the coming years, especially as we have more and more of an uninsured population out there. Those of us who are in this space—NextCare included—are very excited to grow and develop this industry and we view the future as being very bright for us.”

-by T.M. Simmons

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