Over the next decade, outpatient volumes are expected to grow significantly.
While demand is strong and the opportunity is considerable, building a successful outpatient practice isn't easy. In addition to clinical expertise, this endeavor requires business knowledge, understanding of the ever-changing regulatory landscape and much more.
Becker's Healthcare spoke with Karl Menezes, outpatient development architect at Siemens Healthineers, about best practices for developing an outpatient strategy and why independent physician owners, private equity investors and health systems don't have to go it alone. Mr. Menezes is part of a growing team that supports Siemens Healthineers customers in launching or expanding their outpatient offerings.
Editor's note: Responses have been edited lightly for length and clarity.
Question: Outpatient imaging and surgical volumes are expected to surge in the next 10 years. How are healthcare leaders responding to this trend? What are key areas of opportunity?
Karl Menezes: Healthcare leaders understand that more physicians will be leaving the traditional hospital space and for various reasons, such as wanting more autonomy in their professional and personal lives. Many of these leaders are looking to partner with physicians and physician groups in joint venture-type relationships that are mutually beneficial in providing patients with greater access to care, as well as having access to more capital and patient volumes that health systems or established sites of care can provide.
Another key opportunity for healthcare leaders is understanding the potential financial benefits of an outpatient practice. From a cost perspective, ASCs, for example, can be significantly less expensive for both patients and payors. Patients' access to care is more readily available and margins for providers are much greater, which has a huge impact on physician satisfaction. As price transparency for procedures grows, more patients are shopping for affordable healthcare options performed by qualified physicians.
Another opportunity is fully understanding the population health of the area and the services that patients will need now and in the future. Physicians who leave health systems typically don’t have a single specialty under their roofs. They will likely expand their services by joining or starting multi-specialty practices.
Q: What is an outpatient development architect, and what makes this role different from other consulting services in the industry? Why do you think such a unique role now exists to support physician owners?
KM: Outpatient development architects support business planning for both independent physicians and health systems that are looking to separate or expand out from the traditional hospital space. Siemens Healthineers is the only medical technology supplier in the market that offers this level of service. As an outpatient development architect, I bring deep experience in clinical administration and business development to the table. I can speak to the day-to-day operations of the practice. My goal is to help customers at the beginning of their journey as they branch off from the hospital space, and to build relationships based on trust.
In this role, I determine how Siemens Healthineers can support our customers from an equipment and services perspective, as well as in ancillary areas of business. For example, I can help answer questions like where to set up a practice and what services should be offered based on patient population demographics and reimbursement potential. I support our customers’ vision from day one of operations, as well as five years down the road when they may want to expand their services.
Q: Can you talk about some of the services you provide and why they may be valuable to our readers?
KM: My consultative services include building a proforma so customers can better understand the business feasibility of starting a site of care outside the hospital. To start, I use the customer’s current and projected data to model the business case for branching off or expanding out from the traditional hospital setting. This helps determine whether they can build a real business. For years one through five, I identify projected patient volumes, payer mix and potential revenue, as well as what the customer can anticipate for capital and operational costs.
Then, I use large data analytics tools from Siemens Healthineers to provide better insights into patient demographics, payer mix information and reimbursement trends. These data points help customers make more informed decisions.
Q: What are some of the questions you’re asked most often, or areas where physician owners or others may need the most support?
KM: Physicians are really good at being physicians, but they may not fully understand what it takes to build and sustain a business. Knowledge of regulatory and legislative requirements especially is an area where physician owners often need more information and guidance. Sometimes physicians simply don’t know what questions they should be asking. We help them identify these questions and then use our collective internal expertise to answer them.
Q: Is there anything else you'd like our readers to know?
KM: Both health systems and independent physicians face many of the same challenges when assessing the feasibility of opening and sustaining an outpatient practice. The outpatient development architects at Siemens Healthineers can support all provider types—and sizes—in developing and executing an outpatient strategy. Afterall, in order to truly transform the system of care, we all need to work together to bring quality care closer to patients—wherever they are.