Using clinical data to understand trends in outpatient care
Outpatient care has skyrocketed in recent years—and is expected to grow still higher in the next decade. While inpatient care was once a primary revenue driver for many hospitals, it has not kept pace with the rapid growth of outpatient care. Driven by several factors, these shifts away from inpatient care require hospital leaders to assess how these changes will impact their bottom line.
Clinical data are especially valuable as hospital leaders navigate site-of-care shifts. These data hold the key to understanding what types of care patients are seeking externally and determining suitable care settings for patients’ needs. Additionally, because facilities will still need to collect and report high-quality clinical data for many registries, the need for high-integrity clinical data will remain paramount even in areas where changes are expected.
This white paper discusses the key drivers of site-of-care shifts, potential impacts, and the important role clinical data play throughout these changes. It presents market analytics data from Q-Centrix to demonstrate how clinical data can be used to identify patterns in site-of-care shifts. Finally, this paper shares considerations for hospital leaders as they prepare for the changes ahead.
Clinical data are especially valuable as hospital leaders navigate site-of-care shifts.
As CMS removes procedures from the inpatient-only list, opportunities arise for ambulatory surgery centers (ASCs) to provide more services. CMS recently removed 11 services from the inpatient-only list for 2023.
Disparate impacts by service line.
Higher-risk patients using emergency and inpatient services.
With some patients turning to urgent care clinics and other non-hospital sites for emergency services, hospitals’ emergency departments may see a higher influx of sicker patients. An aging population and a rise in chronic diseases may result in a nine percent increase in inpatient stays.
Invest in clinical data
Because data can help hospital staff detect shift patterns and determine appropriate care settings for patients, having the right tools and resources to access and analyze clinical data across care settings is paramount. Partnering with a third party for clinical data management services helps health systems ensure high data integrity and allows clinical staff to focus on patient care.
Evaluate hospital spending
Given the effects of these shifts on hospitals’ bottom lines, hospital leaders should take a close look at their spending and consider where it makes sense to cut costs. Conducting an assessment—a focused analysis to identify hospital costs and areas to align operations, reduce costs, and focus on high-value activities—can help hospitals maximize their resources.
Look for improvements in reporting processes
For many service lines and registries, the need for hospitals to collect and report quality clinical data will not change. When streamlining operations, hospital leaders should empower staff to find new ways to improve existing registry reporting processes. This may include working across departments to update staff on changing guidelines or holding focus groups with clinical teams to brainstorm new improvements.
Build a larger presence in outpatient care
By partnering with ambulatory care sites or building outpatient sites themselves, hospitals can grow their involvement in outpatient care while continuing to serve patients’ needs. According to a McKinsey survey, 41 percent of healthcare providers are building outpatient facilities to prepare for a shift to outpatient sites of care.
Consider new partnerships thoughtfully
Partnering with existing ASCs is a common approach for hospitals interested in expanding their outpatient care reach. As with any strategic decision, due diligence is key. Some factors to consider when evaluating ASCs as potential partners include operating expenses, patient satisfaction, lease terms and obligations, payment rates, ongoing and historic caseload, costs of performing specific procedures, and ASC coding practices.
While the changing healthcare landscape brings challenges for hospital leaders to navigate, it brings new opportunities as well. Patients can benefit from lower costs, shorter recovery times, and fewer complications—and, with some planning, hospital leaders can streamline operations and meet patients’ needs on the new frontier.
To contend with services shifting to outpatient care, hospital leaders should harness the power of clinical data, which offer valuable insights into the services and procedures patients are receiving outside of the hospital setting. This information can be used to guide decisions about where providers should focus their efforts to best serve patients and ensure the continued success of their facility.
Meanwhile, in areas where shifts are not expected—such as collecting and reporting clinical data for registries—hospital staff can take stock of their processes and consider ways to implement improvements and efficiencies. After developing a plan for moving forward, hospital leaders will be better equipped to provide patients with quality care in the setting most suitable for their needs.