TOPSHAM — A one-stop-shopping health care center that’s being called the first of its kind in Maine is opening at the Topsham Fair Mall, but is there enough demand for such services in the area outside of the hospital setting?

When Lewiston-based Central Maine Healthcare unveiled its plans for the Topsham Care Center, the promise was improved accessibility. Located in the former site of Best Buy and Dollar Tree, CMH is introducing an outpatient service it says is the first of its kind in Maine.

“It’s definitely a different way to deliver health care,” said Melissa Caccamo, director of ambulatory services. “It took a lot of collaboration and a lot of provocative questioning of our partners and even our caregivers.”

Patient focus groups and staff input went into the decision-making behind the new care option. The space will offer urgent and cancer care, imaging, lab services, and rotating health clinics under one roof.

Outpatient clinics aren’t new in their own right, but the concern among hospitals essentially boils down to supply and demand. Maintaining the right amount of service within a given region to avoid a higher cost for consumers.

“With the influx of for-profit organizations, there’s an influx of services,” said Mid Coast Hospital spokesperson Judy Kelsh. “When organizations are starting to leave their region, that’s good for jobs, but that starts to develop a competition.”


Mid Coast Hospital is part of a nonprofit organization, but when similar services move into an area it effects the overall cost for the customer, or patient. According to Kelsh, it’s a part of a larger conversation that needs to be had in health care. A conversation centered around what the impact is for consumers when similar services move in.

“I think it’s part of the bigger conversation that’s happening nationally,” said Kelsh. “I don’t know that we have a fix, but we are committed to providing the community affordable care. It’s a question that needs to be asked in health care.”

Kelsh also noted that the new Topsham Care Center is affiliated with an organization that has hospitals with overhead costs. CMH officials cite the new model as a means of saving money for its patients by offering care in an outpatient setting, resulting in a lower fee structure paid by the patient or collected by the provider.

According to Director of Public Relations Kate Carlisle, each facility under the CMH umbrella is run as a separate entity. Costs are based on the overall cost of operating the location.

Urgent care is set to open as an additional service Sept. 17.

“One of the great things about urgent care next door is if, for example, somebody comes in with a sports injury or something that requires imaging,” said Carlisle. “We have the imaging services right here.”


Accessibility and cost drove CMH to look at this new model of care. Caccamo said a visit to an urgent care center is less costly for a patient, citing the overhead operational costs of hospitals. As an example, a hospital requires staffing around the clock.

“One of the reasons those are higher is that supporting a giant medical center is expensive,” said Carlisle. “It just makes sense to have smaller ambulatory areas for some things.”

“There’s definitely a lot of things you can’t go to urgent care for,” said Caccamo. When you get to that level of care that’s where you should be, but there’s really a lot of times where it’s things like a kid with an ear ache.”

While the lone provider of around-the-clock coverage, community hospitals are mindful of the challenge of providing affordable care. Mid Coast Hospital in Brunswick merged with Parkview Adventist Medical Center in 2015. Nearly 200 employees were absorbed under the new health system’s umbrella. The merger brought a closure of Parkview’s emergency room and inpatient services.

Since then, Mid Coast-Parkview has seen a benefit for its patients in the reduction of duplicate services. According to Kelsh, Mid Coast has been able to meet the needs of the community with its services. Meeting those needs while eliminating the same services has resulted in a 30 percent lower cost compared to other hospitals.

“What we provided the community is something of a safety net,” said Kelsh. “We saved the community $8 million every year after.”

Melissa Caccamo, director of ambulatory services, stands in front of the “living wall” in the Topsham Care Center’s atrium. (Chris Quattrucci/Times Record)

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