Though not necessarily a new typology in healthcare design, microhospitals are seeking to address other factors that are new: a mercurial set of financial, operational, and patient loyalty constraints that will continue to evolve as a different presidential administration comes into play this month.  It is helpful to understand some of the considerations our clients and others have weighed as they contemplate the efficacy of a microhospital within their broader network of care.

University of Missouri Health Care, Orthopedic Institute Microhospital

A Facility for the Unknown…

Healthcare organizations and systems were somewhat conservative in their spending in 2016 in anticipation of the presidential election in November.  As such, capital spending scaled back and numerous systems made smaller and/or more incremental facility investments.  The microhospital is a building type that allows healthcare systems to test demand in new communities or provide enhanced services in established markets without expending nearly as much as they would for a traditional greenfield full-service hospital.

…Yet Familiar in Its Capabilities

Though smaller in size and more focused in its services, a microhospital is still a hospital.  Patients can, and do, seek them out for inpatient services with the kind of convenience and access they have come to expect through the robust outpatient facilities that these same systems have brought into the market in the last few years.  Regulations around design, construction, and use follow the more stringent requirements of a hospital and, consequently, may be more difficult to implement in some states than in others.  Certificate of Need and states’ departments of health can play large roles in determining the feasibility of this typology.  Geographic concentration in Texas, Colorado, and some parts of the Midwest is not unusual given these regulatory environments, therefore microhospitals may not be a competitive option available to all.

Shifting Services for Balance

For those systems that are introducing microhospitals, the general strategy at play tends to be concentrated on expanding the system’s geographic footprint while decanting lower acuity services from near- or at-capacity higher acuity hospitals in the system.  The system is then able to strive for providing care in a lower cost environment (microhospital) while reducing the burden of significant expansion to campuses that are often land-locked (urban higher acuity hospital).  This creates a win-win for patient access and financial viability.

Healthcare was once considered an industry where change occurred at a glacial pace.  The last decade has challenged that stereotype and the coming year is likely to apply even more pressure for more change.  Will microhospitals be the next big story or were they merely a brief chapter that is set to close?

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