Both private and public payers have enforced strategies whose aim is to reduce the inpatient hospitalization rates. As Nickals et al. (2017) observed, ambulatory care has been improved which has led to a decrease in the demand for acute hospital care. Other strategy used is stabilizing severely sick patients and discharging them from the emergency department (ED) after a duration of examinations. Consequently, private payers have embarked on contract based on value agreements with facilities of health to enhance ambulatory care which decrease healthcare expenses (Michael & Thomas, 2013). According to Academic Library (2014), outpatient services, have advanced in technology which have permitted health providers to conduct various surgeries on an ambulatory basis which previously would be done on an inpatient basis.
Treatments that are offered in a health facility and require the admission of a patient are termed as inpatient services as they focus on more acute sicknesses. Example of services for this care are complex surgeries, giving birth, rehabilitation for issues like severe injuries, and serious illnesses which demand close monitoring (Wahiawa General Hospital, 2020). On the other hand, outpatient services entail provision of proceedings in health facilities without an individual being admitted as the procedures take hours to be completed. As Wahiawa General Hospital (2020) records, these outpatient services include but not limited to lab tests, minor surgeries, radiation treatment, follow-ups and consultation, X-rays and other imaging.
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Due to the increasing numbers of people pursuing health under the established model of value-based reimbursement, new strategies of delivery are progressively adopted to cater for this demand. For example, the US healthcare workforce are part of the community paramedics which respond to 911 calls and offering direct care on-site (On Medical, 2014). Therefore, they are able to direct patients to a substitute care setting apart from the ED. Also, other physician practice outside the hospital like in outpatient clinics hence facilitating care after discharge thus decreasing readmissions rate as On Medical (2014) observed. Others are positioned to bring care to people’s doorstep using designed care like free-standing EDs and urgent care centers owned by insurers.
References
Khing, T. (2020). PG&E Recognized as One of the World’s Top-10 Training Organizations. https://www.pgecurrents.com/2018/03/21/pge-recognized-as-one-of-the-worlds-top-10-training-organizations/
Academic Library (2014). Hospital-Based Ambulatory Care. https://ebrary.net/13535/health/hospital-based_ambulatory_care
Michael, E. P. & Thomas, H. L. (2013). The Strategy That Will Fix Health Care
https://hbr.org/2013/10/the-strategy-that-will-fix-health-care
Nuckols, T. K., Fingar, K. R., Barrett, M., Steiner, C. A., Stocks, C., & Owens, P. L. (2017). The shifting landscape in utilization of inpatient, observation, and emergency department services across payers. Journal of hospital medicine, 12(6), 443-446. https://www.journalofhospitalmedicine.com/jhospmed/article/139189/hospital-medicine/shifting-landscape-utilization-inpatient-observation-and
on Medical, F. (2014). The Impacts of the Affordable Care Act on Preparedness Resources and Programs: Workshop Summary. https://www.ncbi.nlm.nih.gov/books/NBK241393/
Wahiawa General Hospital (2020). Inpatient vs Outpatient Services…What’s The Difference? https://www.wahiawageneral.org/inpatient-vs-outpatient-services/#:~:text=OUTPATIENT%3A%20DISTINGUISHING%20THE%20DIFFERENCES%20IN,the%20hospital%20to%20stay%20overnight.&text=Outpatient%20care%2C%20also%20called%20ambulatory,that%20doesn't%20require%20hospitalization .
