New Texas hospital banking on patients

If physicians could design their own hospital with everything they and patients would want, could the finances work? In Dallas, Texas, the many players in the regional healthcare system are about to find out.

In April, Walnut Hill Medical Center opened as Texas’ newest hospital. Attempting to be unique in the competitive North Texas healthcare market, it is as an independent facility – not owned or even affiliated with another hospital or health system.

Walnut Hill’s leaders are hoping that high-performing clinicians, ideas borrowed from Apple, Ritz Carlton and Starbucks, and a warm, natural light-filled building design will draw in patients who have a wide range of choices for hospital services in areas like cardiology, orthopedics and outpatient surgery. They hope to perhaps even inspire imitators and competitors.

“We are completely banking on the patient experience and exceptional quality and as long as we do everything right for the patients, the finances will fall into place,” said Cory Countryman, Walnut Hill CEO, told Healthcare Finance News.

Almost a decade ago, cardiologist Rich Guerra, MD, and other Dallas-area doctors from the North Texas Heart Center and CIVA Cardiovascular Specialists wanted to build their own hospital from scratch – with every aspect of the design guided by what physicians and patients would want.

Then came the Great Recession and access to credit slowed, followed by the Affordable Care Act limiting physician-owned hospitals. But the doctors found a way to help design and run a new hospital without owning it, acting as investors offering loans rather than as owners of the hospital, Countryman said.

This spring, after two years of construction, the 100-bed, for-profit hospital, with a 16-bed ICU and 10-bed ER, opened – just across the road from Texas Health Resources’ 898-bed Presbyterian Hospital.

It was something of a once-in-a-lifetime opportunity to build a hospital anew, said Countryman, who was the first Walnut Hill employee hired, in January 2013, after working in executive roles at Weatherford Regional Medical Center, Cleveland Regional Medical Center and Community Health Systems.

“What drew me was the ability to create a culture all our own,” he said. “There’s no hangover culture from a hospital that’s been around for 40 years. We had that luxury.”

Since the hospital is banking on patient satisfaction, patients at Walnut Hill will be treated to some luxuries: all private rooms with 42-inch plasma screen televisions, complimentary valet parking, iPads and free Wi-Fi, a bistro where clinicians are encouraged to dine with patients and families, a Starbucks, a movie theatre and 100 pieces of original artwork, commissioned by the hospital.

Walnut Hill leaders have also instituted new guiding policies borrowed from customer-focused industries, like the hotel industry. For instance, the Ritz Carlton’s “15-5” rule has been adopted at Walnut Hill. Hospital staff will smile at patients from 15 feet away and greet them at five feet.

From retail, Walnut Hill is adopting concepts from Apple and Starbuck’s. From Apple stores came the idea of getting the names of patients as soon as they come in with the thinking that a bit of personalization will help put anxious patients at ease. The hospital has a Starbucks on site as its source of all things coffee, but hospital leaders also wanted to borrow the relaxing ambiance of its stores in the design of its rooms and waiting rooms, Countryman said.

Another overall design theme Walnut Hill used is natural light – something that’s gaining traction in architecture broadly and specifically in buildings, like hospitals, that are meant to be places for healing. “We have a lot of windows,” Countryman said. All of the ICU rooms, too, have windows, the better to help patients get back into the natural rhythms of day and night and avoid the increasingly-acknowledged problem of ICU delirium.

All of these features, while demanding significant upfront cost, should have a healthy long-term return on investment, Countryman argued. Offering amenities such as free Wi-Fi, for instance, is “just the cost of doing business” in these times of patient-centered healthcare, Countryman said.

Attracting patients is a task that’s starting to take care of itself in part through word of mouth. Walnut Hill in now working to nail down insurance contracts. The hospital is taking Medicare and Medicaid and should have commercial plans contracted by August, Countryman said. He said the hospital is also hoping to contract directly with employers.