Identify the major factors that have caused a shift from inpatient hospitalization to ambulatory care services. What are the implications for hospitals, consumers, and the entire health care system?
Sample Paper on: A Shift From Inpatient Hospitalization to Ambulatory Care Services Essay
A number of years ago, there were two worlds in relation to the outpatient care. These two worlds are what most hospitals offered within a defined facility although with limited outpatient services and what most physicians offered in their offices. According to many individuals, the outpatient was usually an addition to stressed inpatient departments since incredibly little thought was provided for cost control, convenience and amenities. Over the years, the growth of services delivered outside the hospitals has taken greater heights creating a special ambulatory environment drive in all health care facilities. Ambulatory care offers a wide range of services that are mostly not provided for patients that do not receive hospitalization. These services are performed in outpatient clinics, diagnostics and imaging centers, urgent care centers; same day surgery centers community health care centers and group practices (Commission, 2004).
Cost
The main reason for the adaptation of the ambulatory care services (ACS) is the shift from inpatient setting to the outpatient one. For this reason, many hospitals have adapted the creation of large ambulatory care facilities through either expansion of existing buildings or building new facilities. The ambulatory services have been on the increase since the early 1980s mainly because of the United States government call to control health care costs. Patient and total healthcare costs are often lower for care provided in Ambulatory Centers when compared to other healthcare settings. In this era of increased transparency, patients will demand a pay for performance system. Consumers of healthcare services should be provided with quality and cost information to facilitate informed decision-making. A Government Accountability Office (GAO) study comparing ASC with Hospital Outpatient Department (HOPD) costs demonstrated that the cost of an ASC procedure was 84% of the cost of a hospital procedure (Devers, 2003).
Given the relatively narrow focus of these facilities, it is expected that ASC outcomes and quality will continue to improve, but data comparing outcomes and quality in the different settings is currently not available. Essential to any determination of value is the assessment of payment adequacy. Current methodology used to update ASC payments is concerning in that it may not accurately reflect ASC cost structure.The development of ASC-specific price indexing, using ASC cost data, would more accurately credit ASCs with the true value they deliver. Additionally, adoption of this methodology would go a long way in addressing the payment parity issue commonly raised when ASCs are compared to hospital outpatient departments.
Technology
In addition, the increase in technological advances has ensured that many surgeries and tests that could only be done in inpatients procedures could be done in freestanding clinics or even centers. New technology is the main driver of the expanding list of procedures suitable for outpatient delivery. Surgeons and procedural physicians not only develop, but more importantly refine the applications and indications for new technology.11 Orthopedic surgeons should and will continue to play a central role in this process (Commission, 2004).
Ambulatory services have taken another increase turn mostly because most investors and insurers have limited their reimbursement fees to specific centers. Actually most insurers have constantly refused to cover the full costs of specified procedures in the case where their patients acquired assistance in inpatient settings. However, this should not worry patients since various hospitalization equipment have been adapted in the recognized centers hence providing quality services. The change is aimed at ensuring that the population health across the care continuum is managed hence keeping a lot of patients healthy through primary care services and preventive care services. Although most people believe that hospitals are entitled to offer the care services, it is essential to realize that the only place where most individuals would acquire quality services is a place away from the hospitals. This is because the right place to offer the specified care with a manageable cost outline, and the right quality would be the ambulatory centers. If patients are redirected to ambulatory centers, they ensure that physician’ offices, online and telephonic interactions, and clinics have less work.
According to many researches and as mentioned earlier, cost is a primary factor that is driving to the success of the ambulatory health care services. Many individuals have argued that most procedures when performed in outpatient surgery centers have a thirty to sixty percentage less cost that the identical surgery in inpatient hospital setting. Owners of ambulatory health care centers are eligible to join the society for ambulatory care professional where they can registers their employees to acquire standards and education on the same (Wanjay, 2011).
Ambulatory centers, by design, focus on a limited scope of procedures. The concept that simplicity and repetition breed competence is believed to be applicable in industry as well as medicine. This relatively narrow focus promotes higher levels of competence among care providers, increased quality, and improved efficiency. Orthopedic surgeons are uniquely positioned to drive ASC innovation toward focused factories since many of the procedures currently performed in the ambulatory setting are orthopedic interventions.
Implications to hospitals and consumers
Hospitals are continually facing competition from registered health care centers that can offer ambulatory services. For this reason, most hospitals have taken in to expanding their services hence minimizing confrontation between these two groups. In my opinion, out patient surgery has grown to become scheduled, elective and profitable. It has greatly enhanced the money making processes in various health centers and hospitals hence the great sense of competition for the bets services. Consumer preferences are the best ideal when it comes to the hospitals changes. For instances, most hospitals are developing programs that are aimed at meeting most consumer demands for both convenience and cost.
It is essential to realize that the main goal of changing the inpatient systems is to manage the populations’ health across the care continuum hence keeping all the patients healthy through primary and preventive care services. Consumers have always been encouraged to attend outpatient services since they are entitled to convenient scheduling. Over the years, people have confirmed that ambulatory centers offers better health care services quoting safety and professionalism as the main advantages.
Although most advantages are aimed at the patients, it is essential to realize that providers and payers also benefit. Payers are able to negotiate more favorable rates for procedures performed in the ASC which lowers their overall costs of care.  Providers which are part of the ASCs have seen large economic gains as they’re able to take economic stakes in the operations.  Overall, ASCs have grown to become an important part of the care delivery landscape and as the three advantages listed above might dictate, this an area that can be predicted will have an increasing relevance in the healthcare landscape.
References
Affairs, H. (2010). Ambulatory services. Health affairs , Pp 283.
Commission, M. P. (2004). Medicare Payment Policy. MedCare , Pp23.
Congress, R. t. (2010). Medicare Payment Policy. MedPAC , Pp 105.
Devers, C. (2003). Focused Factories? Physician-Owned Specialty Facilities. Health Affairs ,
Pp 6.
Wanjay, B. (2011). Heathcare Changes. Health care Journal , Pp 76.

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