The drumbeat for reducing healthcare expenses is reverberating in every market. That drumbeat, along with the drive to better coordinate care as prescribed in the healthcare reform bill, has spurred some unexpected partnerships.

In Las Vegas, two top health systems have deputized retail clinics in the fight to cut avoidable medical expenses. Walgreens-owned Take Care clinics and five Valley Health system hospitals will attempt to reduce emergency room admissions through better coordination.

Another health system set the precedent for Las Vegas; in late 2010, St. Rose Dominican's three area hospitals contracted with CVS-owned MinuteClinic. That deal goes even further by permitting St. Rose Dominican-affiliated physicians to serve as medical directors at MinuteClinics.

In a city that never sleeps like Las Vegas, the extended hours and quick visits that retail clinics supply are a natural fit. Retail clinics have grown rapidly and enjoy consumer popularity; most health plans have provider contracts with them. The connection between clinics and health systems is the next logical step.

Owned by Universal Health Services, Valley Health is Las Vegas largest hospital system, accounting for more than one-third of the region's acute-care beds. St. Rose Dominican, a nonprofit hospital owned by Dignity Health, the former Catholic Healthcare West, is the third-largest, with 19 percent of inpatient discharges and 14 percent of inpatient beds. The region's providers also include Southwest Medical Associates, a large multispecialty practice vertically integrated with UnitedHealth Group-owned Health Plan of Nevada, which has extended-hours clinics.

These retail clinic chains now perform a pivotal role: Keeping patients out of the emergency room. ER staff will refer patients with minor ailments to the clinics, and the clinics will send people with acute illnesses to the hospital. Take Care and MinuteClinic accept most major Nevada insurers. Given the state's 22 percent uninsured rate, one of the nation's highest, the clinics could also present uninsured Nevadans in the ER with a cheaper treatment alternative.

Valley Health and Walgreens intend to expand the deal to allow patient medical data sharing. If a patient shows up at the ER, staff can review electronic medical records to determine the best avenue for care.

There are several winners in the Valley/Take Care deal: Hospitals could benefit from a lower ER wait time; health systems and retail chains can benefit from a deeper partnership; and health plans will save on medical costs with care delivered at a less-expensive location.

Should the latest partnership succeed, we can count on one other thing: what happens in Vegas definitely won't stay in Vegas.


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