The healthcare industry is undergoing seismic shifts as health systems transition from traditional hospital-based care models to community-based and outpatient care models. This change, led by several factors that we’ll explore below, requires systems to adapt to the changing landscape and implement strategies to remain competitive.
Many factors are driving the shift to outpatient care:
Pressures to revolutionize the healthcare payment model: The pace at which healthcare costs are growing is unsustainable in the long term. Major players such as CMS and large commercial insurers are committed to shifting payment models from fee-for-service models to value-based models.
Technology advancements: Technology advancements such as telemedicine are creating the ability for patients to access care, especially in rural areas. Additional advancements in technology are allowing procedures that were once performed in hospitals to be performed in outpatient settings.
Rising cost of inpatient care: Traditional inpatient care in the hospital setting is very expensive, and health insurers and employers are looking for ways to reduce costs. Shifting care to outpatient settings can help to reduce costs, as outpatient care is typically less expensive than inpatient care.
Increasing prevalence of chronic conditions: Chronic diseases such as diabetes, heart disease, and cancer are increasingly common. These diseases can often be managed in outpatient settings, which is more convenient and affordable for patients.
Growing consumer preference for alternative delivery models: The increasing roles of retail clinics and home healthcare offer convenient options for patients who require care but don’t want to seek care at a doctor’s office, hospital, or nursing home.
Building a future-ready health system that accounts for the dramatic shifts in settings will require forethought and planning to ensure patient needs are met and systems can continue to provide best-in-class care. Health systems should consider employing protective strategies that future-proof their organization. Such strategies include:
Developing new care models: Health systems need to develop new care models designed to deliver high-quality care in outpatient settings. This may include developing new clinical pathways, using team-based care, or integrating care with social services.
Investing in outpatient infrastructure: Health systems need to invest in outpatient facilities and equipment to meet the growing demand for outpatient care. This may include building new outpatient clinics, expanding existing clinics, or investing in new technologies such as telehealth.
Realigning their workforce: Health systems need to realign their workforce to meet the changing needs. This may involve training existing staff on new care models, hiring new staff with the skills needed to provide outpatient care, or reducing the number of inpatient staff.
Partnering with other healthcare providers: Health systems need to partner with other providers, such as physician practices, urgent care clinics, and home health agencies, to provide coordinated care across the continuum. This will help to ensure that patients receive the right care at the right time in the right setting.
Using technology to support outpatient care: Health systems can use technology to support outpatient care in several ways. Telemedicine can be used to provide remote care to patients, electronic health records can coordinate care across different settings, and data analytics can identify patients who are at risk of complications.
The healthcare industry is undergoing a major transformation, but it is also an opportunity to create a system that best manages the care of local communities. By becoming agile and focusing on strategies that address shifting consumer needs, health systems will be well-positioned to succeed in the coming decades.