Health systems ride the outpatient wave

Health systems are actively shifting care outpatient in an effort to transform the traditional care delivery system and focus inpatient resources on high acuity procedures.

In June, Sg2, a Vizient company, issued a forecast projecting hospital capacity will change over the next decade, driven by higher patient acuity, staffing shortages and the push to outpatient care delivery. Outpatient surgical volumes are expected to grow 18 percent over the next decade to 109.5 million cases, according to the report, with total joint replacements and spinal fusions leading the way.

"The shift to the outpatient setting is only intensifying, and at Ochsner, outpatient care continues to be a focus of our strategy," Pete November, CEO of Ochsner Health in New Orleans, told Becker's. "First off, it's what patients want. People want to go home after a treatment or a procedure to heal with their loved ones; it's more convenient, more flexible and less costly."

Ochsner invested in a new outpatient medical complex earlier this year offering primary and wellness care, lab services, outpatient surgery and more. The system also partnered with Novant Health to scale its 65-plus clinic model and expand outpatient care for the senior population. The customized approach provides medical and social support in addition to wellness resources for the aging population.

"Shifting more care to the outpatient setting is also the right thing to do to truly make a difference in improving the health of our communities across the Gulf South," said Mr. November. "As we accelerate value-based care, outpatient care is an important part of how we partner with people on their health to keep them well, rather than treating them after they're sick or injured."

David Lubarsky, MD, CEO and vice chancellor of human health sciences at UC Davis Health in Sacramento, is also re-imagining the inpatient hospital's role within the larger system.

"We're adapting our hospital to care primarily for higher acuity patients, as we expect low acuity inpatient care will virtually disappear from hospitals, especially academic medical centers, over the next decade," Dr. Lubarsky told Becker's. "For example, inpatient care like orthopedics is moving to a purely outpatient practice, along with other previously inpatient treatments."

Ronda Lehman, president of Mercy Health Lima in Ohio, said the system's strategy has evolved in the last three years, sparked by the desire to stay out of the hospital during the COVID-19 pandemic.

"It is imperative as we look towards the future of healthcare, that we consider the 'entire' person, not just the episodic hospital care we delivered in the past," she said. "From lifestyle choices to the communities they live, play and work in – we must view healthcare as primarily outpatient with the occasional inpatient hospital need, a dramatic shift from the traditional viewpoint."

Health systems are building out their ambulatory surgery center networks and expanding partnerships with local and national ASC chains for high quality, low cost care. They're also expanding virtual networks, hospital-at-home, and telehealth capabilities for even more convenient care. Sg2 predicts virtual visits will see 28 percent growth in the next decade, hitting 1.67 billion new and established evaluation and management visits.

University Hospitals in Cleveland is increasing utilization at its existing ambulatory surgery sites while expanding offerings in the near future.

"As healthcare changes, we are adapting to consumer demand by expanding our access through introduction of new sites and care modalities, consolidating to multispecialty practices or adding facilities in key locations to assure we are meeting patients' care needs, where and how they prefer to have them met," Paul Hinchey, MD, COO of University Hospitals, told Becker's. "At UH, we're designing a system of care with many outpatient access points that embraces this new reality."

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