“However healthcare reform turns out, hospitals are going to be more responsible for care provided outside the four walls of their facility,” says Garry Gause, CEO of Brookwood Medical Center.  

Both financially and clinically, he says, hospitals will be finding themselves more at risk for their patients’ well being. Add in impending bundled payments for comprehensive care, and hospitals are seeing a compelling advantage to owning outpatient and acute care businesses rather than purchasing those services from others.

With those changes in mind, Brookwood notably expanded their services this year with several diverse acquisitions. “We can provide more continuity of care this way, and it limits our risk from the clinical side,” Gause says. “We’re more integrated in the care delivery and able to control costs better.”

Home health care presents a perfect example of that. “We’re back in the business,” Gause says. After years of being out of that sector, Brookwood purchased a license in 2012 and visited their first patient this last March. The physical office resides on Brookwood’s campus. “But with the technology we have today, we can dispatch to anywhere in the surrounding counties without adding more bricks and mortar,” he says.

The home health acquisition is meant to help decrease certain readmissions, for which hospitals can now be penalized. That same reasoning applies to Brookwood opening a pharmacy in their lobby this past year.

“Over 25 percent of Medicare patients don’t get their prescriptions filled and not taking meds after discharge. This is one of the major reasons patients are readmitted,” Gause says. “We just want to be sure that patients have access to affordable meds immediately after discharge. We don’t have any plans to compete with CVS or Walgreens.”

Brookwood has also stepped into the quickly emerging medical arena of sleep clinics this year with the purchase of Lakeshore Sleep Disorder Center. Most metro area hospitals now have sleep centers.

Numerous studies have led the government and corporations to now recognize the impact of sleep on cognizance, efficiency and productivity. The Department of Transportation is endeavoring to require mandatory sleep apnea tests for commercial truck drivers.

The sleep disorder acquisition pairs well with Brookwood’s expansion in occupational medicine as well. The hospital purchased their third location in August. “With occupational medicine, it’s so important to get a quick turnaround on sleep studies,” Gause says. “We can diagnose sleep disorders early, get people treated and get them back to work or functioning at a higher level.”

Brookwood’s first occupational medicine center, Alabama Comp, was started on their campus more than a decade ago by Bruce Romeo, MD, MPH, CIME. Brookwood opened their second location in McCalla two years ago. This year, they purchased the Concentra occupational medicine clinic on Oxmoor Road.

“There’s a lot of industry in that area,” says Mike Rickman, Brookwood’s Chief Development Officer. “We work with those employers. We tell them that we have the proximity, the physicians, and we know the industry. We’re like urgent care for their employees.”

A promising market for Brookwood’s occupational medicine clinics comes from government contractors. “Contracts with the government dictate that companies have safe workplaces, so these companies are attuned to taking care of their employees, and they’re looking for a partner,” Rickman says.

That partnership includes expedited emergency room treatment at Brookwood Medical Center and oversight of job-site injury patterns. “If we see a rapid recurrence of illness or injuries, like back injuries at UPS, we contact them and help them figure out the cause, so they can fix their workflow,” Rickman says.

Besides the clinics, Brookwood also continued expanding their primary care network this year. But Gause says all these expansions were planned. “We had our antenna up to see what was out there in these areas,” Gause says. “We’re always canvassing to see what opportunities are available, and looking for ones that meet our plans.”

Brookwood’s future expansion plans include the building of the hard-won, stand-alone emergency clinic due to start construction in 2014. “We’re also getting back more into the therapy business on an outpatient basis. We do that on the inpatient side every day, but this would let us meet the needs for our physicians and patients too,” Gause says.

Other expansions will likely include durable medical equipment since that goes hand-in-hand with home health. “And we’re also very interested in hospice,” Gause says. “We did offer that until 2004, so we’re very comfortable and familiar with that service.”