In the era of health care reform, hospitals will face two new challenges: They will need to run higher-volume, lower-margin businesses, and they’ll be on the hook financially for what patients do even when they’re not receiving health care.

Community Health Network’s new partnership with Walgreens’ Take Care Clinics is designed to help address both issues.

The Indianapolis-based hospital system announced last week that it will form a clinical collaboration with Illinois-based Walgreens--directing patients, records and advice back and forth among Walgreens’ 14 Take Care clinics in the Indianapolis area and Community’s vast network.

Community has relationships with more than 2,000 central Indiana physicians who see patients at roughly 200 sites in the area. It even has five MedCheck clinics, which provide immediate care similar to the Take Care Clinics in Walgreens stores.

But it still made sense for Community to partner with Walgreens because many patients are far more likely to step foot in a drugstore than they are a doctor’s office—and some can be served more effectively in retail clinics, said Kyle Fisher, Community’s chief strategic development officer.

He cited one study that showed 60 percent of patients who visit a retail clinic do not have a primary care physician.

Also, a 2012 study by the Rand Corp. showed that visits to retail clinics quadrupled from 2007 to 2009, reaching nearly 6 million. In response, more hospitals around the country are forming partnerships with retail clinics.

“Health care delivery oftentimes is very fragmented. Patients choose to use different entry points to the health care system,” Fisher said. “This isn’t a decision to undo any of the fantastic work we’ve done through MedCheck and through our primary care practices or even through our employer clinics. This is really complementary as opposed to undoing a strategy that we’ve already had.”

Looked at another way, Community has some patients who come into its system via its emergency rooms at its hospitals, even though they could be served by a retail clinic. The cost of an ER visit easily can be 10 times higher than a retail clinic visit.

Under some provisions of the 2010 Patient Protection & Affordable Care Act, hospitals will be asked to manage the health of a specific population of patients, and to do it for less money than the previous year. So avoiding needless ER use will be in Community’s interest.

“We’re committed to take care of any patient, no matter how they enter the system,” Fisher said. “But as we look at health care reform and population-health management, that’s one of the tasks for us, as an integrated system--to better educate our patients on how to use the system.”

Fisher said Community’s physicians will be working with the nurse practitioners at Walgreens’ Take Care Clinics to develop protocols for how to handle patients in myriad situations.

“Our physicians want to be engaged in designing how that care takes place,” he said.