By Shawn Shepherd
Illustration by Malcolm Garris/PhotoDisc
November 23, 1998

In the last decade many healthcare providers have begun moving toward a new model of care—one that places patients in a supportive environment more conducive to a quick recovery. Patients who once felt lost in large, impersonal hospitals are now finding themselves increasingly in tailored care facilities, where most every practitioner is a specialist.

In many markets there has been as much as a 40 percent increase in specialty care operations since the beginning of the decade, according to the American Medical Association.

Specialty care hospitals generally focus on one area of concern, such as heart care or cancer care, and are staffed by healthcare professionals with that expertise.

New healthcare model

The outcropping of specialty care facilities reflects the consumer-driven healthcare system and the move toward managed care, say industry consultants. "Consumers are more and more a factor in the whole development of health care," said Terry Murphy, president of Cleveland-based New Health Management. "Patients are now demanding lower premiums for their care and are more aware of and concerned about outcomes and comparability. What this has done is force providers to rethink what they’re doing."

Specialty healthcare facilities have a long history in the United States, experts say, particularly in the area of children’s health and orthopedics. The emerging trend, however, is single care facilities for diseases. The facilities often offer higher-quality patient care and greater efficiencies, leading to higher profit margins, experts say.

Patient-centered care

"This kind of care is the most patient-centered," said Heidi Osroff, spokesperson for Saint Vincents Comprehensive Cancer Center in New York, one of the nation’s first specialty cancer centers. Osroff said the center offers a "one-stop shop where all of the staff knows all of the patients—it’s a way of meeting all of their medical, psychological, financial, and spiritual needs in one place."

Susie Luther, RN, of the Northeast Louisiana Cancer Institute, says the center’s success stems from its careful concentration on patients. "The special care that our patients get—we zero in on their needs—is what makes this place so important." The 2-year-old facility in Monroe, La., is the only comprehensive cancer care center in the rural region.

Some believe care is better at specialty care facilities. "Heart care is a specialty, and we’re able to provide a service that’s better because when you do just one thing, you can do it really well," said Rod Bryant, controller for the managed care division of MedCath Inc. The Charlotte, N.C.-based MedCath is creating a model for specialty health care that includes four heart hospitals. The company plans to open four more heart hospitals within the year, including one in Bakersfield.

Lisa Person, vice president of clinical services for a soon-to-open MedCath hospital in Austin, Texas, is pleased to be building on the new healthcare model. "Our presence is a benefit to the community for several reasons. Cardiovascular disease is a primary specialty, and when you do it again and again, you get better at it," Person said. "We are also able to have a higher quality staff and better efficiencies in our processes."

"When you work at something every day, you get to be an expert," said Margaret Creane, RN, CEO of Los Angeles’ Barlow Respiratory Hospital. The expertise that specialty care facilities bring to the table is also beneficial in terms of medical science, Creane said. "We have a research department that maintains a huge database, and we’re well-published in the field," she said.

Orthopaedic Hospital in Los Angeles also fills a research need and recently opened the International Center for Orthopaedic Education, said James V. Luck, the hospital’s CEO. "It is the research, medical education, and service components that make this facility special," he said.

Better patient outcomes

Specialty care facilities appeal to more than just the bottom line, however. Spokespeople also report better patient outcomes, shorter lengths of stay, reduced complication rates, and greater patient and care provider satisfaction. All of these indicators make specialty care facilities a safer bet for managed care organizations that demand the highest levels of efficiency, experts say.

"This is really a natural progression for health care, and it is attractive to managed care because … our numbers stand up very well to other facilities’," MedCath’s Bryant said.

Staff in these hospitals say the work in specialty care facilities places demands on the professional. In addition to having more knowledge of and interaction with patients, care providers must excel in the role of educator, providers agree.

"If you can teach people what’s going to happen to them, they usually go through the treatments a lot better," said Mary Ann Robbins, RN, of M.D. Anderson Cancer Network in Texas.

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