Hospitals can learn a lot from Urgent Care Centers (UCC) and ever emerging wellness specialty clinics.
You may think this article is all about UCC’s and wellness centers and it is but moreover it’s a call to action, to boldly go where many hospitals have not gone, bringing new innovations and technology driven service lines into their hospitals, opening wellness centers and UCC’s. Hospitals are witnessing unprecedented disruption that is reshaping the future of everything in healthcare. All hospital CEO’s need to look beyond where the eyes can see, at the flood of health care innovations and technology to improve quality, add value, reduce cost: to bring in more cash paying customers. A prediction is that in the very near future, patients paying cash for services will represent over 8 % of a hospitals business volume and bottom line profits.
Hospitals are being outperformed and have lost major market share to UCC’s and wellness clinics. They have established a perceived difference in delivery, customer service, and cost and value proposition. It is time for hospitals to compete with UCC’s and wellness clinics. Hospitals can build their own UCC, a virtual UCC and wellness and longevity clinics. Hospitals can move many innovative services that are offered in the UCC’s and wellness clinics back into the hospital for cash only service. Wellness and Boutique medicine is exploding and taking hospital outpatient volumes to new lows. Hospitals would be wise to adopt and employ many of their innovative, cash paying business tactics to compete and survive in the ever changing outpatient space. UCC’s are direct contracting with insurance companies, industry and customers. I hope this article will serve to provide all hospital CEO’s a road map to the amazing opportunities in development and implementation of a UCC or wellness clinic and bringing tests, procedures and service lines back into the hospital. The UCC and wellness clinic models and the huge array of service lines discussed in this article are all in place now: customers love them and are willing to pay cash for many of the services offered. Hospitals should consider the concepts discussed in this article (some logos are displayed) that can be deployed at any hospital now, to compete in the huge battleground for outpatient market share and cash paying customers.
I recently visited a nearby Hospital CEO, who had an Urgent Care Center (UCC) open over the past two years in his small town. I questioned the impact on his hospital and he said “none really, they are only open during the day and half day on weekends. Our ER volumes are about the same; don’t get many referrals from them”. So we took a quick look at his ER volumes, self-pay were up and non-Emergency visits; those triaged as being non-emergent ( sore throat , rash, ear infection, pink eye, upset tummy, head ache, etc., etc.) were down. Non-emergent visits were down, especially in the commercial insurance bucket, self-pay were up. Cash flow decreased on steady downward line over past two years from the ER. Also, his lab and radiology volumes were down, again with marked decrease in commercial insurance. He and I went to lunch and drove by the UCC, parking lot almost full. His ER volumes were about the same but his payer mix had definitely changed.
It’s not just about change in volume, payer mix, and cash flow: Hospitals are being beat with quick, fast, convent care at an acceptable price point, and customers are willing to pay cash for all services rendered. Some of the wellness clinics in town, were offering feel good IV’s, weight loss, quick labs, hormone therapy, telehealth-specialist clinic, precision medicine and genomic testing. Where has all the outpatient business gone? – Just look outside your window.
I have visited with UCC’s big and small in Mississippi, Chicago and Tennessee to do some of my research. I also talked with emerging UCC management and boutique medical/wellness companies. For hospitals, UCC’s and boutique clinics present both major challenge and huge opportunity. Some of the findings will be quite provocative and may move some status quo CEO’s off the fence, regarding the emerging supermarket of UCC’s and centers. The UCC’s have embraced a philosophy centered on the patient first rather than the provider and meeting their real need. Real need simply stated for the” new generation of health consumer”: providing quick, fast, convent care, at a low cost- where they want it, when they have the need. They are even willing to give a little on the quality side of care, for fast and low cost care.
A general theme voiced by all the UCC CEO’s, was they are seeking to erase the boundaries of the health care business as it stands and are developing accessible, vertically integrated systems of care that are convent, affordable, wellness based and technology enabled. They also, recognize that they do not need to own all the system components and they can be assembled, through partnerships and virtually through technology. They show a willingness to push experimentation and innovation at every turn using technologies: precision care, virtual and wellness everything.
I found the UCC’s and boutique medical clinics to be focused on meeting patient need through accelerating and expanding from their basic traditional footprint, into the world of nutraceutical supplements and vitamins, cenegenics, pharmacogenetics, precision medicine, preventative medicine- offering annual physicals, wellness panels, providing wellness IV’s (mixing “Myers cocktails“ to make you feel better, fight flu, virus, reduce stress/ fatigue and hydrate the skin as a result of accelerated ageing ), sale of DME, nutritional counseling Botox/ skin peals, BioT ( Hormone therapy), PGx testing, telemetry monitoring ( holters) ,industrial medicine ,on the job injuries and direct contracting, onsite Multispecialty Telehealth clinics (cardiologists, psychiatrists, ENT’s ,etc..), telemedicine via your smart phone or computer, pharmacists consults on demand , massage therapy , podiatry ( toe nail clinic) , hearing aids and wellness offering phentermine and lipo/B12for weight loss. They have nifty scheduling and referral systems, web sites; even offer referrals from the UCC to local physicians. You can make an appointment or walk in; they help with non-acute care, wellness and much more. Some provide telehealth visits and health coaches and/or certified annual wellness specialists that change the paradigm of Chronic Care Management, helping the older patient live well and age well.
The UCC tactics and strategies are wellness based and very aggressive, focused on pulling all profitable outpatient business lines from hospitals. They are erasing the traditional boundaries of business and they are on a health and wellness journey. UCC’s are forming longitudinal relationships, looking to serve micro markets, focused on covered lives and targeted populations. They provide advanced technology –enabled care with; anywhere, anytime services, with a system of care executed through partners. See more in “Exhibit A”.
UCC’s are leasing out big spaces, so they can sublease space to ancillary health care professionals (this helps pay for the building) labs, pharmacists and boutique companies. They offering paid ads on their websites for the health professionals help referrals and brings in more income. Some UCC’s are actually Rural Health Centers cloaked as a UCC. Depends on your model, some are: Medicaid/commercial, just commercial insurance, just women, just men, or longevity UCC’s and wellness centers. There are multiple combinations, choose what fits you best.
The list of combinations of services offered goes on all the way up to a new wave of super urgent care centers. UCC’s are moving from playing one instrument to full symphony. The next new innovations on the horizon: telehealth UCC’s, longevity health, precision medicine and wellness boutique centers driven through age management medicine. Pharmacogenomics lab testing will be in high demand in the longevity/wellness side of the business model.
Many larger systems have opened their own UCC’s through partnering, extending owned physician practices to non-traditional hours or building their own free standing UCC. If they tried to run them like a hospital they failed. There is a Hospital system in Chicago who has successfully opened several UCC’s in shopping centers and food stores. Also, there is a UCC in Chicago providing innovative care that is simply world class and provides almost every outpatient service a hospital can and more. It can be done. Hospitals are typically not built to run UCC’s. They can do it on their own but need extensive research and planning or use of consultants. Most of rural hospitals have not entered into the UCC marketplace or have looked to do boutique medicine in their hospital space or off site: what an amazing opportunity.
Recent hospital surveys show 37% of hospitals currently participate in Convenient /UCC center’s through ownership or partnerships. 14% of hospitals plan to participate in the next 3 years, 46% have no plans, with 3% not sure. Over the next few years looks like a 50/50 split on participation in UCC’s. What’s in your strategic plan?
Now Walmart, CVS and Aetna have entered into the fray forming another disruptive, nontraditional alliance. Why? They seek to disrupt the long stagnant, cost ridden hospital industry, partnering to offer low cost, more convenient access to care. Amazon, Berkshire Hathaway Inc., and JP Morgan-Chase are also getting ready to make waves due to the ballooning cost of healthcare. Now more than ever, Hospitals must be willing to pivot experiment and join in the outpatient revolution to meet consumer need and demand. Chris Van Gorder. President and CEO of Scripts Health, recently said “healthcare is changing rapidly with huge growth in ambulatory care and reduced utilization of inpatient hospitals, and given the elimination of the individual mandate under the Affordable Care Act, the uninsured will once again be growing nationally, We’ve got to shift our organizational structures around to be able to deal with the new world of healthcare delivery, find ways of lowering our costs significantly. If we don’t we will not be able to compete”. Compete with whom? One huge disruptive competitor would be the UCC’s and wellness centers. Their business model is also focused on what hospitals need most; volume in the form of patients and CASH. UCC’s and wellness centers are for the most part, a cash and carry business – they ask all of their customers: “What’s in your wallet? Cash, check, or Master card please.” Some even, accept insurance cards!
Hospitals cannot overlook the silver tsunami, the rise of the baby boomers and age medicine management. The current baby boomers, those 55 and older, see old age as a myth. Many hospitals seem to be stuck in an outdated mind set of inpatient admission and senior care units. Our society is living longer than ever. Medicines greatest accomplishment, in the twenty first century, may well be –human longevity, through the extension of life. Any investment a hospital can make in the boomer generation to help them live longer and live will, will be profitable.
Baby boomers control 70 % of the disposable income in this county, want to live well and will live longer. They want better health and to contribute to society long beyond the magic retirement age of 66. In the very near future, there will be a society where being 100 years old is the new normal. Boomers want to be seen as givers not takers. Congress seems to see them solely as cost drivers to Medicare, senior housing and social security. Hospitals can help the boomer generation and those following them, through a focus on wellness and age management initiatives.
It’s time to think big, be bold and “give consumers what they want!” Some may see it as disruptive innovation; and sit on the sidelines; others will seek to provide patients with high quality care, in the right setting, as demanded by their patients, at the lowest cost with positive outcomes. Hospitals need not look at this as disruption but seek to redefine clinical models, to integrate care, reduce costs and create new revenue streams. Hospitals need to look at connecting all the dots throughout the full continuum of a patient’s life cycle. Most all can be provided in the hospital setting or through a UCC.
Hospitals can offer many of the services and procedures discussed in this article, inside the hospital, in the form of wellness/boutique cash only clinics. At a minimum, hospitals should offer telehealth and precision medicine (genetic/molecular testing) and wellness (see lots more in exhibit “A”). Hospitals can open a UCC, offering all minor care services, women’s and men’s wellness, lab, telemedicine services, longevity age management and precision medicine. Additional models and services that Super Urgent Care centers are currently offering or will be offering are listed below. .There is some, additional 41 services to consider in embracing a philosophy centered on the patient, rather than the provider. The list grows exponentially as more innovations are offered by wellness clinics and UCC’s every day. Boutique medicine and UCC’s are alive with opportunity. So, maybe it’s not time for hospitals to reform, transform or merely change, perhaps it’s time to get in the game… go out and bring in new innovative line of business into the hospital like molecular testing and virtual everything or build – a Super Urgent Care Center. It’s time for hospitals to look beyond where the eyes can see, joining in on the disruptive innovation and technological revolution going on in health care – just outside their window!
Exhibit A:
Model/structure: Patient preferences for how they get care and receive care, new innovations and technology, with a national focus on more prevention and wellness are driving new models of delivery. UCC’s or wellness clinics can be an owned, a partnership, joint ventured or managed.
• UCC’s small, huge or telehealth driven: The UCC can be the traditional bricks and mortar. Or can be totally provided virtually through telehealth (with service in English and Spanish). This is an amazing opportunity for all hospitals to use, as they transition to bricks and mortar (or just remain virtual telehealth). Both models can provide limited service or the full spectrum, outlined below. UCC’s can be run with primarily with PA’s and NP’s with occasional visit from the physician. Both can offer pharmacy services. They can be traditional cash for service, with some offering concierge medicine, where patients pay an annual fee. Every hospital in America can have a virtual UCC today; they are inexpensive, easy to set up. They drive business to local primary care, specialty physicians and the hospital. They are highly profitable.
• Rural Health Clinic (RHC): a UCC can be cloaked under a RHC. Medicaid patients need care and may not have a physician. They can use the UCC as their PCP. Much can be done through telehealth to assist patients who have transportation challenges. VA patients are a hidden opportunity.
• Specialty UCC: Occupational medicine /industrial medicine ,women’s medicine, men’s medicine, wellness and longevity, Chronic Care Management and virtual multispecialty UCC’s are models, beginning to pop all over the country. Telehealth offers a unique opportunity where a physician is not required online or on premises fulltime.
Wellness /longevity medical clinics: These clinics present huge opportunities for hospitals to bring the services on campus or open one in the community. They are springing up in every city small or large. They offer a wide variety of services from precision medicine (genomic testing), weight loss, vitamins, lab testing, wellness IV’s, cardiology, pulmonary, mammogram screens, telemetry monitoring, Botox/skin peels, salt room therapy to health coaches. Hospitals can offer every service and test they do and more on premises or off site, for cash only and insurance can be filed or services like ”Care Credit” offered, to assist the patient in upfront payment.
Space owned /lease: a space can be purchased or leased. The amount of square footage needed will depend on the model selected. Space can be leased to any partner where they complement the mission/model of the UCC, tie to hospital and will produce income to offset operational expense.
Staffing: depending on the model: physician, NP’s, PA’s, pharmacists, nurses, lab, radiology technologists, wellness coach, certified annual wellness specialist and clerical staff may be included in the employee staffing model. The hospital can employ or use independent contractors for physician, ARNP and PA’s.
Software/web site: A cutting edge IT system is a key to success. The IT program will include billing, collections, patient follow up and a scheduling program. All need to have appropriate IT interface and other connectivity as required to the hospital and all other partners. A mobile app can be helpful.
Equipment: Depending on model and services offered, a variety of FF&E can be offered, such as Radiology, lab, bone density, physical and cardiac therapy and telehealth equipment. Also, transportation van is optional according to model.
Contracts: will need appropriate contracts with Medicare/Medicaid, VA and insurance companies in the settings where insurance is accepted , remember many of the innovative services – can be offered for cash only, it is proven by companies like “23 and me” customers will pay cash for perceived value received.
State Licensure and local business license/ governmental: Will need appropriate licensure and certification and all other coverage necessary by Local, State and Federal guidelines.
Retail pharmacy remote /license: will offer small pharmacy and /or consultations through telemedicine or a phone consult. In some states like Tennessee there is legislation called “collaborative care “that allows pharmacists to see patients, provide diagnosis and write a prescription.
Laboratory services: a wide variety of lab services will be provided and may need a CLIA license. (See list below). Precision care and genomic tests are and will be huge.
ATM: strike a deal with a local bank for cash paying customers for a bank cash machine.
Care Credit: a company that helps finance small balances or elective services like Botox.
Reimbursement: With mega changes going on in the health care industry its best to do an industry snap shot of the specific test, procedure, service, a market landscape survey, perform due diligence, do an return on Investment(ROI)analysis and have health council opine on any contacts, considerations of health care law or legal requirements. Under the free standing UCC and the wellness centers model, at this time it’s best to bill under professional services. In the future this could change as CMS made some regulatory changes in reimbursement in the bipartisan budget act of 2015, section 603 for provider based departments located off campus. When opening services off campus it’s always best in the (ROI) analysis, to feather in any cost report impact.
Precertification for many genetic tests are required by some insurance companies. They also, will not pay for most genetic tests that are not considered medically necessary. Keep an eye on CMS guidance, industry standards, evidence –based medicine and denials to make decisions on cash payments.
Web page or mobile app overview and marketing: The web page/app will include advertising’s. There are many good ones on the market. Online booking and check in, follow-up emails and notification system. Also an interactive web site/app allowing for scheduling appointments, payments, contact us ... etc. Web site will include ads, which will generate income for the UCC. Marketing and ad campaign, with appropriate brochures and handouts will be needed. Mobile Apps can provide excellent marketing for any products or services.
Listed below are the service lines that can be included inside a hospital, wellness center or Super UCC Model:
1. Basic minor care services offered : will include the standard services offered like minor cuts and lacerations, cough ,cold, sinus infection, earaches, UTI infections, sports injuries, drug testing, nausea/vomiting/diarrhea , etc. ,etc.
2. On site pharmacy- a small or super large on site pharmacy can be offered through the hospital or local pharmacies in the UCC or wellness center. All major medications are available and mail order direct can be offered to the patients home for refills. Home delivery of medications can be offered, partners abound to assist, Amazon and Uber. Some states like Tennessee have “collaborative Care” legislation and pharmacists can see patients (in person or telemedicine) and write prescription and bill through telemedicine parity.
3. Concierge wellness center or UCC: This is an optional plan offering a set number of limited visits to unlimited visits for a set price. Included is annual wellness visit. It’s a twist on per patient per month contracts and is consumer driven .Patients sign up because of certain reasons; such as high deductibles (not reported to insurance plan) or underinsured, patient knows he has several complications and or comorbid conditions. Its good financial planning and super convenient.
4. Telemedicine – Healthcare is on a rapid journey to virtual everything including wellness clinics and UCC’s.
• Clinic visits for minor care needs can be done via telemedicine or a patient can come to UCC. Patients can have a visit on site with a primary care provider or a specialist. If inconvenient to come in to a UCC patients can be treated discreetly with a live video conference. Also, if requested, patients can have a telemedicine visit with their primary care doctor and after treatment a follow up appointment with your primary care physician can be made, if patients approve. Service can be provided in English or Spanish as well as other languages.
• Schools/universities, prisons, home, cruise ships industrial accounts, and hotels: virtual, compressive care can be delivered to a variety of setting confidentially, in compliance and discreetly.
• Tele-business/industry: This is a virtual onsite clinic. Employees never leave the building. Improves employee morale, recruitment, and satisfaction and employee time off from work along with reduced cost and paid replacement overtime. For business and industry this will soon be considered a main stream benefit.
• Tele-Multispecialty clinic – telemedicine can provide improved chronic care management – patients can visit with their specialist from the UCC multispecialty clinic for new visits, quick care or follow-up visit, if inconvenient to drive to your specialist’s office. Yes this means patients do not have to drive long distances, fight big city traffic and search for parking. Even lost paid work time will be greatly reduced.
• Telemedicine – telemetry monitoring: outpatient Holter monitoring and ECG telemetry can be offered on an outpatient basis remotely, through the hospital or a UCC monitoring station and read by cardiologists from anywhere, with virtual office visits.
5) Veteran’s clinic: Basic medical care will be offered, to include precision medicine genetic/molecular testing, behavioral health services. A secondary vision with the President’s focus on improving access, is to enable the veterans to rebuild their lives improving access to care and leading a healthier life by precision medicine, customizing their care especially for wounded warrior’s to bring care closer to the veterans ‘home and extend care to them especially through discreet telehealth visits. Can be offered 24/7 especially tele psychiatry.
6) Chronic care management (CCM) and wellness visits (WV): Some spins can be done on CCM and wellness visits. A good software program can schedule WV’s and CCM firms can help with following patients weekly and monthly, a face to face is the best way to follow-up.
7) Radiology: X-Ray equipment for chest and bone exams. Perhaps bone density for longevity and women’s center section. Mobile mammography, bone density, hearing, pulmonary, heart and ultrasound screening is a great opportunity. UCC schedules on certain days and sends out to area communities if needed.
8) Precision/ personalized medicine-Laboratory in office: UCC and wellness clinic Labs can be small to huge as needed in coordination with the hospital or reference lab. Doing everything from allergy testing, quick drug 12 panel drug screens, genomic to toxicology with resulting. Personalized medicine is amazing opportunity through pharmacogenomics and molecular testing. General wellness blood panels (women’s and men’s), health panels and a variety of other syndromic testing can be offered under the routine and personalized lab test umbrella.
9) Center on wellness and Longevity: The purpose of the center will be to provide seniors with a long healthy lifestyle- living longer and living well. This innovative center will focus on Age Management Medicine and Wellness (molecular/genetic lab testing), located in the UCC for geriatric care and education for customers 55 and older. There are boutique companies like 25 Again, 23 and me and Cenegenics that do genetic testing. These genomic tests can be provided through precision medicine or similar tests like a PGx test or a BioT – for Hormone therapy, can be offered in the center. Annual wellness exams will be offered by certified annual wellness specialists. The medical professionals will provide an in-depth consultative visit including an individualized plan of care for the patient focused on health and prevention. These certified coaches will guide the customers to succeed in meeting their longevity goals through the continuum of health and wellness: nutrition, exercise, weight management, smoking cessation, stress management, to include behavioral health and opioid addiction. Nutraceutical nutrients can be provided as a dietary supplement and can even private label them to the patients for weight loss malnutrition and eating disorders can be offered... IV cocktails will be available for helping patients with chronic fatigue, blood concentrations, immunities, nutrients to protect from germs, bacteria, viruses, dehydration. Pain management and a variety of screening can be offered from labs to pulmonary and mammogram. Massage therapy and nutritional counseling will tie into IV therapy. Botox and blue ray skin care will be offered.
10) Young adult annual wellness visits. Annual wellness exams (genetic testing) and custom tailored wellness plans are offered through medical professionals and health coaches for young and middle age adults who want to prepare now for the challenges of life as an older adult and be there for their progeny.
11) Coordination of care- will book appointments with primary care, specialists, and wellness coaches, make your CT/ultrasound/MRI appointments, and other services.
12) IV infusion center- IV cocktails- to increase blood concentration of several vitamins and minerals beyond what can be achieved orally (i.e. Magnesium, calcium, B vitamins and C vitamins) and can be modified to individual patient needs. They can help with chronic fatigue syndrome, depression, vitamin deficiencies, withdrawals and migraines, with a powerhouse drip. Other IV’s can shield from cold, flu and stomach virus, called an immunity shield which helps protect you from unseen elements. IV’s can provide proper vital nutrients needed in the war against germs, bacteria and viruses. Also, the baby boomers often have chronic dehydration known to result in dry skin, wrinkles, and skin blemishes through accelerated ageing. A custom tailored IV Infusion or beauty drip is perfect for epidermis therapy and prevention of premature aging and harsh environmental conditions their skin faces every day.
13) Telemetry monitoring: Easily prescribed by a collaborating internist or cardiologist. This is a simple monitoring program, excellent for the patients with pre or post cardiac surgery conditions. The 24/7 UCC centers can do telemetry monitoring. Excellent spin off revenue. Also for hospitals under readmission penalty, cuts the readmissions for population health. Can limit trips to the ER, observation status, readmission in 30days and “not real events”.
14) Genomic, pharmacogenetics testing Toxicology - All done at or through the hospital lab or Genomic company partnerships.
15) Dental clinic- represents an excellent service for kids and elderly.
16) Pediatric care: rent space and can deliver service through NP’s and to pediatrician through telehealth.
17) Attention Deficit disorder /AD-Hyperactivity disorder treatment and diagnosis: can screen for the disorder and treat with medical professionals at UCC. Telehealth can be used as needed with psychiatrist or other behavioral specialists.
18) Assistance with Medicaid registration/qualification for card: provide assistance in filling out forms / and location of Medicaid offices.
19) Student health- local schools colleges and universities. Provide athletic physicals. Set up a telehealth school health center and wellness program.
20) Obesity clinic/Weight loss /fitness programs/ nutraceutical supplements: rent space and offer memberships and or do a storefront with partners.
21) Behavioral health and Opioid stabilization/detox program – health professionals can consult and prescribe as needed or set visits with behavioral professionals or psychiatrists at UCC or through multispecialty Telehealth clinic. Adolescent visits offer a huge market and need through school systems.
22) Women’s health- will offer wellness coach and benefits in : plans for customized health , nutrition and exercise planning , decreased body fat, early detection of certain diseases, sleep improvement, body composition /bone density scan, skincare ,hormone therapy for a happy lifestyle, also can offer menopause stabilization, Botox and fillers, Latigge ( eye), Sclerotherapy-spider vein treatment, professional bra fitting. Telehealth visits can be like the Maven clinic.
23) Men’s Health –will offer wellness coach and benefits in: decreased body fat, increased physical and sexual vitality, and increased muscle tone, decreased risk of age related diseases, smoke cessation, improved mental sharpness and sleep quality, chronic care management, older men – shingles injection and annual exam and wellness programs.
24) Travel medicine and cruise ship medicine: can do through telehealth and cash only.
25) Flu vaccines and other vaccines: can do normal flu shots plus pharmacist consults and immunology as appropriate.
26) Chiropractor: rent space.
27) Podiatry: rent space.
28) Eye glass center / doctor: rent space.
29) Hearing aid center: rent space.
30) Employer services/industrial /occupational health/ assisted living - : some UCC’s are doing this with basically telehealth only with a doctor and ARNP’s employee Never leaves the plant in many cases: Drug and alcohol, annual physicals, pre-employment, psychiatric visits, brief physicals (hearing, lifting, eye, EKG, chest x-ray and drug screen) TB testing, Flu vaccines and other immunizations. For industry can offer DOT physicals, direct contracting, flat fee arrangements and narrow network. Use telehealth for quick assessment for on the job injuries- this is huge for the non-reportable for industry. Excellent for follow visits up visits to physician office.
31) Drug testing personal and Industrial/employer health:( many drug tests in less than 5 minutes)
32) Cosmetic services: Botox and other Allergan products will be provided by certified medical injectors and other staff like a PA, ARNP or pharmacists. Facial rejuvenation and laser services for all types of skin.
33) Weight loss and human chorionic gonadotropin (HCG): FDA approved treatment for optimal body wellness. Wellness coaches will set tailored precision plan.
34) Natural food and vitamin store: rent space or private label.
35) Large hotels, Nursing homes, assisted living, movie theaters, airports: advertise for a UCC visit or telehealth visit at area health facilities. Example: large hotels -place a wellness center –sick center / prescription refill in hotel open 8-5 and telemedicine visits from hotel room if on app. Place ads at movie theaters and market to all.
36) Home health visits- through telehealth visits from UCC or wellness center.
37) Home care – through telehealth visits from UCC or wellness center.
38) Wound care-. Minor wound care debridement work done by NP’s at UCC. Can tie in with a wound care center or do follow up at UCC or wellness center.
39) DME: targeted products will be offered low cost high volume (crutches, walkers, etc.), can do mail order and or go through local or national DEM providers- UCC branding can be used...Look at nursing homes, assisted living, home care groups, local gyms and walk-in to general public.
40) Physical Therapy (PT)- rent space. Or use hospital PT to provide scheduled services, help with sports care on Saturday mornings and sports physicals… then refer to hospital or UCC.
41) Mobile mammography, pulmonary, heart and ultrasound: all can be scheduled at UCC and used in longevity center, fitness and population health. Discussed under radiology above.