Northwestern Memorial HealthCare is making a hard push into the northern suburbs, planting its flag firmly in a market dominated by a pair of established competitors before President Barack Obama's health care overhaul is implemented.

Northwestern Memorial Physicians Group, the hospital system's wholly owned primary-care doctors' group, plans to open nine new clinics by spring 2013 from Chicago's North Side to near the Wisconsin border.

Four of the clinics already are open, including sites in Grayslake, Highland Park, Lake Forest and a combination primary care and urgent care center in Lakeview that started accepting patients late last month. Another in Evanston is projected to open in October.

Administrators expect to add as many as 100 new physicians over the next two years, roughly doubling the number of doctors in the Physicians Group today.

The expansion, estimated to cost about $20 million, comes on the heels of the system's 2010 acquisition of Lake Forest Hospital, its first acute-care outpost beyond its core offerings in the city. It also places Northwestern in direct competition with a pair of deep-pocketed rivals: NorthShore University HealthSystem and Advocate Health Care.

Although Northwestern officials insist the move is not an attempt to wrest market share away from its competitors, Ed Giniat, who leads the consulting firm KPMG's health care sector, said the hospital "is starting to throw the gantlet down on a fairly fractured market."

The Northwestern expansion also comes in advance of the 2014 implementation of the health care overhaul, which already has spurred changes in how and where health care is delivered.

The new model places greater importance on primary care physicians, who will take on additional responsibilities in managing patient groups. That has led to a spending spree by hospital systems, which are competing to align with doctors' groups that will be counted on to act as a feeder network of patients.

In Northwestern's case, it is seeking to widen the pipeline of patients to its flagship Streeterville hospital.

"People keep rediscovering the fact that (primary care doctors) are probably the best, most efficient and economical entree into the system," said Dr. Daniel Derman, president of Northwestern Memorial Physicians Group.

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Northwestern Memorial expands into northern suburbs