In the past few years, hospital expansions in Arkansas have captured the public’s attention, but officials said the most important medical care usually happens well before a hospital visit.
At least it should, and Arkansas hospitals are trying their best to improve those chances.
The United Health Foundation released a report in 2018 that ranked Arkansas 46th nationally in overall health. The state was 49th in the number of dentists per capita, 45th in preventable hospitalizations, 43rd in primary care physicians per capita and 45th overall in clinical care measures.
Medical officials in Arkansas have said that making primary care more accessible is a critical need. Chanda Chacon, COO of Arkansas Children’s health system in Little Rock, said the hospital opened a clinic in southwest Little Rock and immediately picked up an influx of new patients, even though the clinic was minutes from ACH’s main campus.
“About 10% of the patients we saw, which were within a 10-mile drive of our Little Rock campus, were new to our system,” Chacon said. “By putting care close to home, those kids were able to get preventive care closer to their families.”
Steve Goss, the president of Mercy Hospital Northwest Arkansas Clinics, said, “Ten miles can be a long distance for certain people.”
It may seem strange in the age of smartphones and technology, but some people who get sick or have sick children don’t have the flexibility or means to take them to the doctor. Preventive care, then, becomes even more of a luxury.
“It seems shocking, but I’m not actually surprised, especially in a state like Arkansas that has such rural areas,” Chacon said. “Transportation is difficult and can be challenging. We have to be really creative as a health care system to make preventive care easier for families to access.”
When Mercy Hospital Northwest Arkansas announced a $247 million expansion project in 2016, most of the attention was focused on the new seven-story, $100 million patient tower that would be built on the Rogers campus. It is scheduled to open later this year.
Almost reduced to footnotes were Mercy’s other big and cumulatively more expensive plans: seven new or expanded clinics in northwest Arkansas that would help dent the medical needs arising from rapid growth in Washington and Benton counties. On Sept. 18, Mercy opened a multispeciality clinic in Springdale — price tag $47 million — including a helipad, 24-hour emergency room and 60 primary and specialty care exam rooms.
Goss said the Springdale clinic will offer specialty care such as pulmonology, neurology and endocrinology. The clinic will add about 24 primary care and specialty physicians.
The most challenging aspect to adding services can be finding the specialty physicians to provide it.
“If you poll a bunch of people in northwest Arkansas about accessing health care, you would probably find out [providing] that is not the easiest thing in the world with the growth and having enough money to grow all the services that we need,” Goss said. “The people often find it a little difficult to find those health care resources that they are needing, especially when it comes to specialty care. That is the reason for our investments, to provide more access in more locations for these people.”
When Arkansas Children’s entered northwest Arkansas, it did so with a bang: the $167 million, 230,000-SF campus west of Interstate 49 in Springdale. ACH’s clinics are in west Little Rock, southwest Little Rock and Jonesboro, and the hospital recently announced plans for a 9,700-SF pediatric clinic at Jefferson Regional Medical Center in Pine Bluff.
One ACH initiative has been a statewide mobile dental program that takes tooth care to children and has been especially effective and popular in rural areas. Chacon said dental care is the “front door” of health care.
“If a child has terrible teeth and a lot of cavities, they’re not eating well and they tend to get sicker faster,” Chacon said. “It really helps to be more preventative and further upstream. We knew that was a strategy we were very passionate about. That helps keep kids in school. That does better for everyone.”
How to make health services more accessible boils down to sustainability questions. A hospital has to get the most bang for its buck, serving as many people as efficiently as possible.
Mercy uses consulting services that research what areas have the population and unserved needs and then determines what those unserved needs are. That research helped Mercy decide on the specialties to offer at its Springdale clinic.
Some areas are tougher to fix. Chacon said an area needs to have at least 70 children per square mile to make a hospital sustainable; Little Rock has 119 children per square mile and northwest Arkansas has 84.
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The next most populous area is Jonesboro with 39 children per square mile. In sparsely populated areas with as few as four children per square mile, a major clinic investment just isn’t sustainable.
Harrison Dean, president of the western Arkansas and eastern Oklahoma region of Baptist Health, said creativity is required for less populated areas. Baptist Health, which acquired Sparks Regional Medical Center in Fort Smith and Sparks Medical Center in Van Buren last fall, is assessing the western Arkansas-eastern Oklahoma region to decide what needs can be addressed.
In other Baptist Health regions with sparse populations, Dean said, the hospitals open wellness centers that operate once every week or two to identify patients who need follow-up care. It’s not a solution, but it does get people in the health care door.
“Clinics are a point of access to the broader health care system,” Dean said. “We are trying to identify where access is an issue. Maybe there is a pocket of geography and population that is not dense enough but does have a need. Where do these opportunities potentially exist?”
Goss said Mercy is trying to attack rural health care strategically. Mercy has partnered with Berryville Mercy Hospital, opened a clinic in Green Forest and relocated a care facility in Eureka Springs.
All three towns are small and in rural Carroll County, whose total population is less than any of the four main cities of northwest Arkansas
“That is our more rural location and outreach,” Goss said. “That is a little bit out there but are nice little communities that need a little more support and access to care.”
Chacon said ACH covers the two main population areas with hospital campuses but its community outreach and dental van program are part of its desire to be a statewide network.
“We’re not trying to build a central Arkansas network of care or a northwest Arkansas network of care,” Chacon said. “We really want to make sure we are reaching those families in small communities with less infrastructure.”