Hospitals and Health Systems have confronted a challenging and turbulent period as the nation has faced COVID-19.  The pandemic provided a temporary shock and reduction in outpatient volumes as patient trends reacted to the threat of COVID-19.  However, the shift from inpatient to outpatient services and continued competition for patients and resources in the ambulatory space remains a dominant theme for health care leadership moving forward.

Outside forces continue to shape the ambulatory market.  The trends of consumerism have been bolstered by regulations requiring price transparency for both providers and payers, with big data providing consumers new insights into their costs and options for care.  Private equity, big tech, and venture capital start-ups continue to bring new money and competition into the marketplace.  Healthcare in the home, value-based care, social determinants of health, and telehealth bring additional layers of complexity to ambulatory care strategies and priorities.

As systems plot their course ahead, a renewed focus on some of the key elements of the outpatient care strategy is advisable.  CMS policy directly drives certification and payment for a significant portion of the nation’s population served by health systems, with other payors tracking many of their key requirements.  Understanding and navigating the core ambulatory care settings defined by regulations provides the backbone of a health system’s ambulatory strategy.

Advis continues to see opportunities for systems to improve their understanding and utilization of ambulatory care settings and programs to maximize their outreach and impact within their communities.  With the rise of site-neutrality from CMS, a detailed understanding of provider-based vs. freestanding developments and associated strategies is critical.

As your hospital begins to develop its ongoing ambulatory strategy, it is important to assess the needs of the community, area providers, reimbursement implications, and the overall cost of the project. Advis is uniquely positioned to provide assistance with each of these tasks, as well as assisting with developing a strategy that meets ever evolving state and federal regulation. For assistance, please contact Advis through our website, or by calling (708) 478-7030.

Published: October 9, 2022