Taking big steps with micro hospitals

For a company focused on building small hospitals, Emerus recently hit a big milestone.

Rachel George, MD, chief medical officer of Emerus, says micro hospitals offer patients high-quality care with short waits.

Emerus announced in September 2024 that it has treated a total of 4 million patients. The Houston-based company was founded in 2006, and hit the 3 million mark in February 2023.

“It’s a huge milestone,” Rachel George, MD, chief medical officer of Emerus, tells Chief Healthcare Executive®. “We're super excited about that.”

“And we've been picking up momentum, and so we went from 3 million to 4 million really quickly,” she adds.

Emerus has teamed with the Allegheny Health Network, Baptist Health System, Baylor, Scott & White Health, ChristianaCare, WellSpan and more to build small, neighborhood hospitals, often called “micro hospitals.”

Emerus has brokered deals with health systems to jointly operate more than 40 hospitals around the country, with more on the way. The hospitals feature emergency rooms with eight to ten beds, and they have some limited inpatient capacity. The micro hospitals don’t perform surgeries or have intensive care units, so patients with more serious conditions are stabilized and sent elsewhere.

Beyond the size of the facilities, the small hospitals also incorporate telemedicine into their care. While the inpatient beds are staffed by nurses who work in person, patients see doctors virtually.

George says the model is working to help people get more access to care.

“We are fully licensed hospitals,” George says. “There is no ‘micro’ hospital, ‘neighborhood’ hospital designation. We are a fully licensed hospital with a fully functioning emergency department.”

Emerus hospitals have treated patients with gunshot wounds, heart attacks and victims of car accidents, among other emergencies.

“We are able to take care of patients, manage, stabilize, and then we transfer them to a facility more appropriate for the illness or the issues that they are having,” she says.

Touting short waits, strong service

Emerus has more micro hospitals slated to open soon.

ChristianCare is teaming with Emerus to build a small hospital in Delaware County, Pennsylvania, a suburb of Philadelphia. Above, an image of the planned facility.

ChristianaCare, based in Delaware, is teaming with Emerus to open three neighborhood hospitals in the Philadelphia suburbs in 2025. WellSpan Health, based in south-central Pennsylvania, is building three hospitals with Emerus. New facilities are being built in Las Vegas and San Antonio, George says.

Ascension and Emerus made a joint decision to close one neighborhood hospital in Wisconsin after “a thorough evaluation of the utilization of services and resources,” including other nearby emergency departments.

Still, several health systems are slated to open micro hospitals with Emerus in the near future. The new hospitals won’t be carrying the “Emerus” label. They’ll feature the brand of their health systems.

Typically, Emerus is setting up in cities and suburban areas to reach communities that may have a longer drive to a large hospital, George says.

WellSpan Health CEO Roxanna Gapstur touted the advantages of the micro hospitals in an interview with Chief Healthcare Executive®. WellSpan is building its new small hospitals in areas that are more than 20 minutes from WellSpan’s larger hospitals.

“They're small and nimble. They also offer access points, right in communities,” Gapstur says.

“Healthcare has too much friction, we all know it,” she says. “It's not easy to access. It's not easy to use. We're really hopeful that these sites will provide a fantastic experience for our communities, too, as well as being more affordable.”

George says a key ingredient to the success of the micro hospitals is that patients can be seen in the emergency department very quickly. She also says patients are typically very satisfied with the care.

“If we are not providing an exceptional service, people would rather drive the extra 30 minutes and go to the larger facility,” George says. “So our wait times are very low. On average, our patients wait less than 10 minutes to see a physician.”

Typically, patients that don’t need to be transferred elsewhere or admitted can be in and out of the emergency department of a micro hospital in less than 90 minutes, George says. Patients don’t want to drive longer and wait beyond those with more critical needs in a larger hospital.

“There are so many people waiting, and there are so many people that are really, really, really sick,” George says. “A lot of people don't need to go to the larger facility to get the care that they need.”

George is careful to note that the services in the micro hospitals go beyond urgent care.

“It’s a fully functioning emergency department that can take care of anything and everything, and then get you to the correct level of care that you need if you need to be admitted,” she says.

Tackling big challenges

For patients that have to be admitted to the micro hospitals, Emerus is using telemedicine to connect patients with doctors. There are no in-person physicians for those patients, which George says can be an adjustment for some patients.

But she says patients appreciate being able to connect with physicians quickly via telehealth.

“Our patients are more satisfied than almost anywhere else that they go, and that is a fully telemedicine physician model now,” she says.

Nurses provide in-person care, and each nurse typically sees three or four patients. With nurses getting more time with patients since they aren’t juggling a high number of beds, they are able to provide more attention in the hospital. They also have more time to provide instruction and prepare them for being discharged from the hospital, George says.

The length of stay for patients in the micro hospitals “is very low,” George says.

“We’re able to get them home,” she says. “And patients really love it.”

The micro hospitals can also help health systems provide more cost-effective care, since they are focusing on patients that need emergency care, or those that may need to be admitted but won’t require a lengthy stay, George says.

“We're focused on a very specific group of patients, and because of that, we can take care of them more efficiently,” she says. “Our length of stay is lower, and we get them and we get them discharged home.”

George sees the potential for micro hospitals to help supplement health systems as they grapple with access and making it easier for patients to get care.

“This will never replace the large hospitals that are out there today,” George says. “That's not our intention.”

But she adds, “This does have potential to really tackle some of the really big challenges that we're having in healthcare.”

George also sees the Emerus model as demonstrating the value of telemedicine, combined with in-person care from nurses.

“Personally, I'm most excited about the proof that we are creating that a telemedicine model of medicine works really, really well,” George says.

“We are proving that we can do this at a lower cost, with improved retention of our physicians and our nurses, and provide great care for our patients,” she adds. “That's really what excites me, and I think it should excite everybody.”