How an ambulatory platform will help hospitals, health systems navigate the shift to a value-based care payment environment

Mary Rechtoris -

Regent Surgical Health CEO Chris Bishop discussed the importance of developing an ambulatory platform as health systems and hospitals are tasked with moving to a value-based payment model moving forward during the Becker's Hospital Review 6th Annual CEO + CFO Roundtable Nov. 13.

Here is a snapshot of Mr. Bishop's presentation.

On the shift to value-based care reimbursement methodologies: "Trinity is one of our partners and two years ago, they set a big hairy audacious goal when they publicly made a statement that 75 percent of their revenues by 2020 would be generated via some form of value-based care. Now, that's way ahead of the curve. We have other partners that tell us that they want to ride the wave into the shore, the fee-for-service wave, and continue to enjoy that for as long as they can. But, you have more progressive health systems out there that recognize it will be painful here as we go through this transitionary period; but we believe and what Trinity believes is come 2020, a lot of their market will have managed care or [they will offer an] employer benefit in their ability to deliver more cost-effective care. When you are going to generate 75 percent of your revenues via some type of value-based reimbursement methodology, you have to have the lower cost setting to deliver that service in."

On the need for an ambulatory strategy: "By 2026, [estimates say] we will double the number of joint replacements. If you don't have an ambulatory strategy around joint replacements — and I would include spine in that as well, which is also a high growth market capable of shifting to the outpatient setting and already has been — you'll find that your competitor or large orthopedic practice has actually scooped this business and you don't get a piece of it."

On converting HOPDs to ASCs: "When I look at our pipeline with our development team, we are looking at all the projects our hospital partners have asked us to assist them with every two weeks. In our letter of intent section, four or five of our projects were hospital outpatient department conversions...We have found that the hospitals looking at the HOPD conversions that have gone from 5 percent of their revenues being generated from value-based care to 30 percent [or] 40 percent. It is a general transition for them on their asset base. But, they are trying to manage somewhat in parallel with the growth on their value-based reimbursement."

On what innovative health systems, hospitals are eyeing: "We have found our hospital partners are very receptive to some unusual ideas. We have not yet done our first birthing center, but we are in the process of building a strategy around it. It is an ambulatory surgical solution and that's what we view ourselves as an ambulatory surgical solutions provider.  A cardiac surgery center is an area that our hospital partners are asking us to help them design.. [Our partners are] understanding this transition in how they get paid and the more care they can shift to the outpatient setting, versus the inpatient setting, the better."

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