The Micro Hospital Model: Overview and FAQ
In our consumer-driven healthcare landscape, it’s important to consider patient needs like convenience and affordability. Micro hospitals — also called mini hospitals or neighborhood hospitals — are small-scale, licensed inpatient hospitals that are designed to be accessible and cost-effective. They’re similar to stand-alone ERs in that they offer 24/7 emergency services, with the difference being that patients can be reimbursed by CMS or private insurance groups at higher rates.
This particular hospital model is an attractive solution for healthcare companies looking to meet patient needs — and it’s beginning to take hold. Emergency care provider Nutex Health, for example, switched over from founding mostly stand-alone ERs to building over 20 neighborhood hospitals across 11 states in their effort to deliver more efficient care.
Here’s an overview of how this facility model works, as well as answers to some frequently asked questions.
What Are Micro Hospitals? Overview
To understand the model, it’s helpful to realize that these facilities are essentially fully equipped hospitals but on a smaller scale. They have inpatient beds, emergency bays, imaging services, and pharmacies — just like large hospitals. However, a typical neighborhood hospital has less than a dozen beds and one imaging room, compared to the hundreds of beds and multiple imaging areas of large hospitals.
Consider the design that Emarus uses for the many neighborhood hospitals they’ve started up over the years. Their typical facility has a footprint of fewer than 50,000 square feet, with a first floor consisting of around 8 emergency bays and a handful of inpatient beds, and a second floor for imaging and medical offices.
Some of these neighborhood hospital models also have operating rooms for simple surgical procedures, or areas designed for ancillary services like family/pediatric care, labor and delivery, and nutrition services.
Frequently Asked Questions About Mini Hospitals
These types of smaller hospitals fill a specific niche in the healthcare industry, often operating within a network of small facilities that offer patients convenient access to care. What sets them apart from other facilities that meet similar needs, like urgent care centers and community clinics? Let’s go over that question and others, so that you have a better understanding of the model.
What is a micro hospital?
Definitions may vary slightly, but there are core requirements for this type of facility. Qualifications largely hinge on the CMS definition of hospital, which states that a facility must have at least two active inpatients at the time of survey, and be “primarily engaged” in inpatient care. CMS judges engagement level through benchmarks like average daily census and average length of stay.
These guidelines have been adopted by other organizations like the Joint Commission, the Healthcare Facilities Accreditation Program, and other accreditation services. It’s now generally agreed upon that mini/micro/neighborhood hospitals are small, acute-care facilities with a focus on inpatient care.
When did they start emerging, and why?
This model of hospital first came onto the healthcare scene around 2007, and grew in popularity over the next decade, with facilities popping up in over a dozen states including Colorado, Texas, Pennsylvania, and Arizona. These facilities provided a middle ground between under-equipped clinics and large, complex hospitals.
In response to the growing number of these facilities, CMS published its updated definition of the term hospital in September, 2017. This made it challenging for facilities to qualify and slowed the trend. However, new small-scale hospitals continue to go up in neighborhoods across the country.
What are the advantages and disadvantages of these smaller hospitals?
There are many varieties of micro hospitals. Pros and cons vary depending on the scope of practice at the specific facility. Here are some to consider:
| Advantages | Disadvantages |
|---|---|
| Easy to navigate. It’s easier for patients to find their way around, compared to the sprawling campus and parking structures of big hospitals.
Better reimbursement rates. Because the care qualifies as “inpatient,” the patient may receive higher reimbursement rates compared to other types of facilities Access to specialists. Many have systems in place for accessing specialists, like cardiologists, that other types of large-hospital alternatives lack. |
Limitations in care. Some conditions will be beyond the staff’s abilities, such as when a patient needs a complex surgical procedure.
Lack of equipment. These smaller hospitals don’t have all of the specialized equipment that larger facilities have, leading to even more limitations in care. Reliance on transfers to larger facilities. When patients are transferred to larger facilities, there is a delay in care. |
What is the level of care offered at mini hospitals?
These types of scaled-down hospitals are acute-care facilities capable of providing emergency services, imaging, lab tests, and both inpatient and ambulatory care. The services offered can be tailored to the community that’s served. For example, one of these smaller hospitals in an area with a high concentration of families may offer limited labor and delivery services, while a facility in a ski town could have an orthopedic surgeon on staff.
What are some factors to consider when thinking of opening a small-scale hospital?
You’ll need to consider state-based regulations, like Certificate of Need (CON) laws. The CON application process can be a barrier to opening this type of hospital because it’s a lengthy and costly process that requires organizations to demonstrate a local need before a facility can be built or expanded. Notably, states like Colorado, Texas, and Pennsylvania, where the first wave of neighborhood hospitals was notably strong, don’t have CON programs in place. Other factors to consider include:
- The potential area’s unique healthcare needs.
- The difficulty in training staff due to infrequently encountered conditions (compared to larger inpatient settings).
- The skilled engineering and extensive planning needs of the micro hospital design. (Think about equipping a relatively small building to meet patient comfort and safety needs.)
Want to Learn More About Emerging Trends in Healthcare?
When it comes to healthcare, there’s no one-size-fits-all model. Creative solutions, like the micro hospital model, have emerged to fill in the gaps. Interested in staying on the cutting edge of healthcare? Get insights into more innovative solutions in healthcare from our team of experts.