Health systems face a critical challenge. As ambulatory care centers gain popularity, hospitals are losing surgical volumes. This shift threatens the traditional model of consolidating all surgical services within main hospital ORs.
Hospital campuses, often large and complex, can be overwhelming for patients and their families. Long walks, confusing layouts, and time-consuming processes present a sharp contrast to the streamlined experience offered by modern ambulatory care centers. Moreover, providers struggle with the inefficiency of mixing inpatient and outpatient cases in hospital ORs, impacting their productivity and work-life balance.
Financial pressures further compound the issue. Insurers are increasingly designating certain surgical procedures as outpatient-only, resulting in lower reimbursement rates for hospitals performing these surgeries in inpatient settings.
To address these challenges, forward-thinking health systems are exploring strategies to develop their own ambulatory care centers. But how can they effectively create an ambulatory footprint that meets patient demands while retaining crucial surgical volumes? Let’s explore the key factors driving this shift and the potential solutions available to healthcare leaders.
The Patient Perspective: Desire for Accessible and Efficient Care
Today’s healthcare consumers are driving a significant shift in how surgical services are delivered. You’ve likely noticed a growing preference among patients for outpatient procedures that offer convenience without compromising quality.
This demand stems from several key factors that traditional hospital settings can’t always address.
Patient Proximity to Local Care
Patients demand surgical options that don’t require long commutes or overnight stays. As such, how close outpatient care centers are to patients’ homes is a top priority. However, hyperlocal care options are not just about convenience. Such facilities can reduce stress and facilitate faster recovery in familiar surroundings.
Ease of Access
Straightforward and efficient access to local ambulatory care centers is another crucial element. Navigating a sprawling hospital campus can be a daunting experience. Rather, patients are drawn to ambulatory care centers that offer:
- Simple, straightforward layouts
- Ample parking close to the facility
- Shorter walks from entry to treatment areas
Atmosphere
The environment of care plays a significant role in patient satisfaction. Ambulatory centers often provide a more intimate, less clinical atmosphere that can alleviate anxiety associated with surgical procedures. This high-touch approach resonates with patients who may feel lost in the bustle of a large hospital.
Efficiency
Efficiency is perhaps the most compelling draw of ambulatory care centers. Patients value their time and expect streamlined processes. In these specialized facilities, you’ll typically find shorter wait times and quicker turnaround for procedures
By addressing these patient preferences, ambulatory care centers are setting a new standard for outpatient surgical experiences. Health systems that recognize and respond to these evolving demands are better positioned to retain patient volumes and ensure satisfaction in an increasingly competitive healthcare landscape.
The Provider Perspective: Streamlining Surgical Workflows
While patient preferences are the main driver of ambulatory care, provider productivity is equally crucial in this paradigm shift. The traditional model of mixing inpatient and outpatient cases in hospital ORs is growing unsustainable.
Hospital ORs often juggle complex surgeries alongside routine procedures. This mix leads to inefficiencies that impact everyone involved. Surgeons must navigate a maze of scheduling conflicts, unpredictable case lengths, and frequent delays. This results in fewer cases per day and longer hours.
Ambulatory care centers offer a solution to these challenges:
- Focused environment for outpatient procedures
- Streamlined processes tailored to routine surgeries
- Predictable schedules allowing for higher case volumes
By separating outpatient procedures from complex inpatient surgeries, health systems can create a win-win scenario. Surgeons benefit from increased efficiency and improved work-life balance, while hospitals can optimize their main ORs for more complex, higher-revenue cases.
The Financial Perspective: Retaining Surgical Volumes
Hospitals’ losses in surgical volumes to ambulatory care centers represents a threat to your bottom line. Ambulatory surgical centers can typically perform procedures at a lower cost than hospital-based ORs. This cost differential is of course attractive to both patients and insurers.
By developing your own ambulatory care centers, you can stem this tide. This enables health systems to not only retain cases but also adapt to a new reality in healthcare delivery. Consider the following:
- Outpatient procedures can be performed more efficiently at ambulatory care centers
- They provide a competitive offering to match other outpatient surgical centers
- Continuity of care within a health system is easier to maintain
However, it’s not without challenges. The reimbursement rates for outpatient procedures are generally lower than those for inpatient surgeries. This means health systems need to optimize operations to maintain profitability. The key lies in volume and efficiency — areas where ambulatory centers excel.
Balancing Cost and Revenue
Developing an ambulatory strategy requires a delicate balance. The aim is to capture outpatient surgical volume while also ensuring hospital-based ORs remain productive. This doesn’t mean cannibalizing existing services, but rather expanding the reach of the health system and adapting to market demands.
By strategically positioning ambulatory centers, a health system’s network complements its main hospital, capturing surgical volumes that might otherwise be lost to competitors. This approach not only helps retain revenue but also positions health systems as a comprehensive care provider, enhancing market presence and patient loyalty.
The Insurance Perspective: Adapting to Changing Payor Policies
The insurance reimbursement landscape is also evolving rapidly, reshaping how health systems approach surgical care. More and more, insurers designating certain procedures as outpatient-only, forcing a reevaluation of where and how these surgeries are performed.
This shift presents a significant challenge for hospitals still relying on traditional inpatient settings for outpatient procedures. When insurers classify a surgery as outpatient, performing it in a hospital OR often results in lower reimbursement rates that may not cover costs.
However, by aligning with insurer preferences, ambulatory care centers can help health systems optimize their revenue for outpatient procedures. Consider the following benefits:
- Better alignment with payor policies for outpatient surgeries
- More favorable cost structures for lower-reimbursed procedures
- Potential for higher patient volumes
By embracing ambulatory care centers, health systems can position themselves to thrive in this new reimbursement environment. It’s not just about adapting to change. It’s about staying ahead of the curve and ensuring financial sustainability in an increasingly complex healthcare landscape.
Building an Ambulatory Footprint: Strategies for Health Systems
As health systems consider developing ambulatory care centers, the aim should not be to simply build new facilities. The ultimate goal is to create a cohesive network that complements existing hospital infrastructure while meeting evolving patient and payor demands.
When planning an ambulatory footprint, consider these key factors:
- Geographic distribution to capture target markets
- Service mix aligned with community needs and payor trends
- Operational efficiency to maximize provider productivity
- Technology integration for seamless patient care coordination
Remember, outpatient facilities are not meant to mimic hospital environments on a smaller scale. Instead, the focus should be creating streamlined, patient-centric spaces that cater to the unique demands of outpatient care.
Ambulatory Care Centers: A Path Forward for Health Systems
By developing their own ambulatory footprint, health systems can effectively address the changing demands of patients, providers, and payors. This proactive approach not only helps retain surgical volumes but also positions health systems as leaders in accessible, efficient, and cost-effective care delivery.
As you navigate this shifting terrain, remember that the ambulatory strategy does not mean abandoning hospital-based services. Rather, the goal is to create a complementary network that enhances the overall care delivery model. Strategically integrating ambulatory care centers makes it possible to optimize resource allocation, improve provider satisfaction, and meet the growing consumer demand for convenient, high-quality outpatient services.
The question isn’t whether to develop an ambulatory strategy, but how quickly and effectively you can implement one to secure your position in tomorrow’s healthcare landscape.
Written by: Carolyn Wilson, Chief Operating Officer and Steve Christoff, SVP, Design Innovation Development