Convenient and efficient settings for diagnosing and treating a wide range of medical problems are often found in ambulatory care facilities rather than in hospitals. With the ambulatory care facilities of the current generation, patients get much more than just clinical space. These innovative designs promote continual development and accommodate changes in how healthcare is provided, along with changes in technology and interactions between doctors and hospitals. They also suit the demands of a more urbanized population and draw new patients to health systems.
Here are some trends that are shaping the realities on the field:
Direct-to-employer arrangements are already in place at more than 80 health systems. Intel and Boeing have worked with providers to develop risk-sharing, total-cost-of-care care models for their workers.
To preserve and expand its commercial-segment business, academic medical institutions like Mount Sinai Health System in New York are working with startups such as One Medical to offer concierge-like primary care, along with other excellent urgent care providers.
According to a Silicon Valley Bank study, healthcare venture investments in 2018 were 50 percent greater than in 2017 (about $25 billion), with significant investments in cancer and neuro medicines, biopharma platforms, cardiovascular and neuro devices, and diagnostic tools and analytics2.
Meanwhile, consumers are expected — fingers crossed — to behave more like “customers,” increasing the incentive for health insurers and providers to solve access and cost problems.
With this kind of change approaching, healthcare executives should devise a plan to address the major themes.
While revenue growth in the broader healthcare industry has slowed over the last decade, ambulatory clinical demand has remained strong. Truven Health Analytics predicts that the combination of population growth, aging, treatment patterns, Medicaid expansion, and coverage via healthcare information exchanges would result in a 21 percent increase over the next decade.
The increasing proportion of the elderly in the overall population will have a significant effect on ambulatory services. According to Truven Health, the balance of the population over 65 will increase from 15.1 percent to 18.8 percent by 2025. The impact of the approximately 17 million people who have gained coverage via state and federal health marketplaces and Medicaid expansion adds to this demand.
Outsourcing Becomes a Trend
National physician practices (NPPs) – single-specialty, groupings of related specialties, and multispecialty — have largely escaped the attention of most strategic debates. Because hospitals often collaborate with NPPs to address clinical staffing shortages, they are rarely seen as direct rivals. Nonetheless, NPPs are the center of considerable venture capital activity, with physician shortages driving fast rises in practice value. NPPs have an edge in recruitment because of their size and specialized specialization, especially for jobs such as hospital intensivists and emergency medicine4.
The NPP scale enables management techniques that better match clinical staffing with hospital and payer requirements, resulting in a more comfortable patient care experience. Several NPPs, including Sound Physicians, have been active participants in Medicare bundled payment efforts, opening the door to possible joint-venture agreements with provider networks looking to shift resources from inpatient to ambulatory care.
According to a 2019 Accenture study, customers’ expectations for convenience, cost, and quality are changing. Younger customers, as anticipated, are more unhappy with the status quo in healthcare. Still, consumers of all generations are more ready to explore unconventional services, with convenience being a top consideration in care selection. Large businesses, the government, and insurers are increasingly turning to improved forms of primary care as a means of boosting access, reducing costs, and meeting market demands.
The increased demand for high-quality primary care services and the adoption of new value-based payment methods and venture capital investments fuel the development of new kinds of ambulatory care providers. Outside of the ER, telemedicine businesses and urgent care clinics can cover some of the gaps. These clinics are equipped with the much-needed services and equipment to provide excellent patient care.
However, primary care companies with a care model that can offer genuine involvement, regular conversation, and collaborative patient/physician decision-making may be more transformational in the long run.
The ambulatory business may be thought of as a portfolio of consumer assets with distinct contractual methods, centralized billing, collections, and financial administration, and a different set of performance measures that match the interests of health systems, owners, and doctors. A shared vision and common objectives, explicit knowledge of what each partner contributes to the business, and a procedure for addressing operational issues are required for successful joint ventures.
Organizations should commit to standardizing, predictable, and effective business processes, agile to meet changing customer purchasing habits, and emphasizing on-demand access and convenience via investments in new technologies.