What health systems can gain from shifting sites of service?

advent florida health systems

For better or worse, healthcare is a market commodity. Patients as care consumers have a plethora of options as to where they spend their healthcare dollars. National pharmacy chains, such as CVS, and big-box stores are increasingly developing themselves into full-spectrum providers supported by their impressive infrastructures. Tech giants, like Amazon, have brought into the space plans to scale efficiency and delivery of care. Insurers, Optum being one, are maneuvering themselves into positions as care providers as well as underwriters.

Traditional health systems find their position – at least somewhat – threatened. That threat is only amplified by the challenging financial losses that many systems faced during the COVID-19 pandemic, increased labor costs due to staffing shortages, and the scourge of inflation pummeling every industry.

Because of all this, the need for health systems to differentiate their offerings and compete with players who are offering easier access and lower costs is more important than ever to their survival. Certainly, there are titanic systems that through sheer size and/or via acquisitions will weather storms on the horizon. But smaller systems find themselves in uncertain waters. This can be catastrophic not just in terms of dollars and cents and jobs lost, but in access to care for millions of Americans.

Staying on top of change

Evolution in healthcare is constant and necessary. What would have once been unthinkable, like telemedicine, is becoming routine. Physician’s Assistants and Nurse Practitioners regularly serve as primary care providers. Vaccines no longer require a physician or RN to administer them but are available at most every pharmacy.

Procedural sites of service are shifting as well. What once required a surgeon, an OR, and full surgical team, such as colonoscopy, balloon sinuplasty, endometrial ablation, or cataract surgery, can now be done safely and conveniently within a surgeon’s own practice. This sea change in care delivery has spelled savings for patients and insurers, increased reimbursements for physicians, and comfort and convenience for both the patient and the provider.

As most health systems are anchored by a network of hospitals, it may seem antithetical to embrace office-based procedures. However, health systems with the foresight to adapt to changes in the industry and marketplace can – and have – made office-based procedures an important part of a model that understands and embraces the needs and desires of patients and respects the autonomy of their network providers.

Focusing on what matters

Patient experience and engagement are paramount considerations when it comes to standing out in a crowded marketplace. While hospitals are an indispensable part of the healthcare ecosystem, they are a poor fit for many types of care. Patients often view interactions with hospitals with trepidation. From long waits or overnight stays to impersonal care to skyrocketing costs to the elevated risk of infection, many avoid hospitals for all but the most necessary care.

It is exactly this reasoning that led to the creation of ambulatory surgery centers. ASCs continue to offer patients a valid and needed alternative to hospitals by excising many of the extraneous elements of care delivery incumbent to hospitals. Similarly, offices and clinics as sites of service further reduce burdens that come along with care in an ASC.

Think about it. If a physician opts to perform an ethmoidectomy in their office, they’ve eliminated the need to schedule the procedure at an HOPD or ASC and submit themselves to the whims of a fickle schedule that can devastate their whole workday. Neither they nor their patient travel to an off-site location, but rather have the convenience and comfort of undertaking needed care in a familiar setting with known, trusted staff. The patient will likely incur reduced out-of-pocket costs while the payer eliminates a large facility fee from their bottom line. This adds up to a higher reimbursement for the physician.

So how does this help a health system stand out? Payers are already incentivizing – or outright mandating – shifts in sites of service from HOPDs to ASCs to offices and clinics. Fighting the inevitable will only get health systems so far. But embracing office-based procedures and what they offer patients and providers serves to engender loyalty among the patient-base and staff alike. Patients who realize they are being treated fairly and offered the treatment options that are inline with their needs are apt to stay within a health system for the whole of their care. And, fostering an atmosphere of respect for physicians and their autonomy as care providers and decision makers can help attract and retain talented staff during shortages.

Photo courtesy of ahs856/Wikimedia Commons

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