Joshua Hall, associate professor of economics and director of the Center for Free Enterprise at WVU’s College
of Business and Economics,
led the research effort, looking specifically at the entry of MedExpress
neighborhood medical centers into Appalachian counties between 2001-13. The
research paper, entitled “The Effect of Health Care Entrepreneurship on Local
Health: The Case of MedExpress in Appalachia,” found that urgent care centers
are beneficial to rural areas in multiple ways.
Researchers at WVU’s business school said the positive impacts resonate to the needs of Appalachia: urgent care centers drive positive health outcomes, and the region also represents fertile ground for entrepreneurial healthcare ventures. Hall and co-author Amir B. Ferreira Neto found that the entrepreneurial activity represented by these medical facilities in Appalachian communities had positive impacts on the local economy.
“Because rural areas are sparse in terms of population and firms, getting certain types of businesses to thrive can be difficult,” the study read. “As a demand-driven industry, health care provision can suffer if there is not enough demand in an area due to low population. UCCs typically charge a lower price and are faster than hospitals and emergency rooms… especially for non-life-threatening issues. Additionally, if the lower cost or easier access is making people more likely to seek medical help sooner, individuals who end up utilizing hospitals should be healthier and thus need fewer days in the hospital upon referral.”
That, Hall said, is an attractive business model in rural America — lower costs, faster service, staying away from hectic emergency rooms, easier access to non-emergency healthcare and improved access to medical information. He also said that the positive health outcomes of urgent care centers in Appalachia are difficult to ignore.
“We found that areas with MedExpress facilities saw a reduction in short-term hospital admissions, outpatient visits, inpatient days and trips to the ER. And that is, most certainly, a good outcome. In a region where health facilities are both overworked and strapped for resources, that is a good sign,” Hall said.
The researchers used data on all MedExpress openings and looked at how a facility opening changed health outcomes in a county. In order to compare like situations, they statistically matched counties where the facilities opened to similarly distressed counties to be sure that the MedExpress was not opening centers in areas with improving health outcomes.
Research shows that nearly 80 hospitals have closed in U.S. rural communities since 2010, thus increasing the importance of other healthcare providers. That, the WVU study said, is where urgent care centers come into the picture.
“Although not a perfect substitute to hospitals,” the paper read, “UCCs can fill in the gap for the treatment of non-life threating conditions and provide local communities health care at a lower cost than most hospitals.”
With the closure of so many community hospitals, Hall said a concern is the distance many may have to travel just to get to medical care. “Another focus is a rural area where a formal medical facility may be farther away. Urgent care centers are making medical care available in neighborhoods and communities, and some of those are where no other medical facilities may exist,” he said. “It should come as no surprise that these neighborhood healthcare centers are thriving based upon this business model. That’s a positive infusion of entrepreneurship in markets that could definitely benefit from it.”
“I saw MedExpress CEO Frank Alderman speak at a WVU event and, as economist, I wondered what the private sector is doing about healthcare,” said Hall. “I thought that if patients are going to MedExpress, they are not going to the ER for routine medical attention, and that’s what our research showed. These urgent care centers in Appalachia are reducing congestion in the ERs, where true emergencies need to be the priority. And they’re successful business ventures that serve as valuable amenities to rural communities.”
The research paper is publicly available to read or download and is forthcoming in Journal of Regional Analysis and Policy, a peer-reviewed academic journal. The mission of the WVU Center for Free Enterprise is to advance teaching, research and outreach on the free enterprise system and how it relates to increased prosperity and quality of life in West Virginia and the world.
Patrick Gregg, College of Business and Economics