Healthcare reform and financial and operational pressures will shape how hospitals and systems define and act on ambulatory care unit (ACU) strategies, according to a report from Jones Lang LaSalle.
The cumulative effect of these influencers is accelerating changes in the traditional hub-and-spoke model in order to promote broader outreach and greater efficiencies, said Richard Taylor, managing director of Jones Lang LaSalle’s Healthcare Solutions group.
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“The old notion of the hospital as the one-stop shop for all health needs is evolving in a dramatic fashion to the point where the hospital is but one component of an integrated delivery system designed around the patients’ needs,” he said in a press release about the report, “The spoke before the hub: Turning the healthcare delivery model upside down.”
Health systems need to take a fresh look at their ambulatory facility strategies, from site location to design to operations, as a way to enrich care delivery, attract physicians and manage costs. “Achieving superior ambulatory performance in a manner that improves health, patient experience and cost is vital to future success,” Taylor said in the press release.
The report outlines five steps that will help make sure that hospitals and their ambulatory operations evolve in the face of shifting customer expectations and increased pressures on reimbursement. Those are:
1. Understand the full scope of service line capabilities, including service offerings and their impact, so a comprehensive strategy can be developed.
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2. Analyze and rate the effectiveness and efficiencies of the current service delivery so appropriate changes can be applied in a comprehensive plan.
3. Determine market position, including knowing existing and targeted demographics and how each will change and what it means for competitive forces.
4. Identify physician alignment and how a new or revised ambulatory care unit plan will affect staffing needs for existing clinicians and whether additional staff will need to be recruited.
5. Build financial models with a focus on developing payment methods that support a healthcare system that emphasizes delivering value over volume.
According to the report, a key driver for the growing emphasis on ambulatory settings is their cost benefit because they can be established in locations and operated at far less cost than the hospital facility and can also help the hospital system compete with other area healthcare organizations. Ambulatory units can be more easily expanded for community outreach programs for population management and deliver coordinated care in an integrated fashion, and technology and online tools enable clinicians to perform procedures outside of the hospital setting at lower cost.
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