Chapter 7 What is Outpatient Care/Ambulatory Care? | Assessment
Questions and Answers with 100% Correct Answers | Latest Version
What is Outpatient Care/Ambulatory Care? - (ANSWER)Consists of:
· Diagnostic and therapeutic Services provided to walk in patients
· Care for patients who visit physicians, outpatient departments of hospitals
Outpatient Services refer to as: - (ANSWER)· No overnight stay
· Offered at long term care facilities
· Hospitals that offer outpatient surgeries, rehab and specialized clinics
· Basic routine physical exams and minor treatments that are performed in physician office
Advanced outpatient services required are sometimes done at hospitals with outpatient departments
Scope of Outpatient Services - (ANSWER)· Access remains a problem for uninsured and racial/ethnic
minorities.
· Visits are higher in metropolitan areas than in rural areas, reflecting poorer access to primary care in
rural areas
· Outpatient care do much more than primary care services; most surgeries are now performed in
outpatient settings and could be performed at hospitals
· Services shift towards outpatient care and hospital occupancy have declined
· Establishing more Outpatient care market has become a threat to hospitals due to services are
expanding more and has been a competition for medical services between hospitals and community
based providers
Examples of competition: - (ANSWER)· Home health
· Ambulatory clinics for routine services
· Urgent care
· Outpatient surgery
· Dental and optometric services
Changes that have contributed to why there is a shift in balance between inpatient and outpatient
services: - (ANSWER)· Reimbursements
,Chapter 7 What is Outpatient Care/Ambulatory Care? | Assessment
Questions and Answers with 100% Correct Answers | Latest Version
· Technology Factors
· Utilization Controls
· Social Factors
Reimbursement: - (ANSWER)Hospitals have developed outpatient care services to offset the declining
inpatient income because:
· Outpatient care cost less
· MD discharges their patient quicker under prospective and capitated reimbursement.
· These financial factors have provided a major growth of home health care.
Technologic Factors: - (ANSWER)· Less invasive surgical methods and new diagnostic treatment
procedures can be done outpatient that require inpatient hospitals stays
· Less traumatic procedures such as shorter acting anesthetics and minimal invasive technology leads to
shorter recovery times
· Physicians have expanded their capacity to perform outpatient services
Utilization Factors: - (ANSWER)· Inpatient hospitals stays are discouraged by various payors.
· Prior auth for inpatient admissions and minimizing hospitals stays controls costs
Social Factors: - (ANSWER)· Patients would prefer health care in the home and community-based
settings.
· Being home gives individuals a sense of independence.
OUTPATIENT CARE SETTINGS AND METHODS OF DELIVERY
Private Practice - (ANSWER)· Physicians in and office settings form the backbone of ambulatory care.
Provides:
· Limited examinations and testing
· Encounters with doctors in short duration
· Waiting time is longer than the time actually spent with the doctors.
, Chapter 7 What is Outpatient Care/Ambulatory Care? | Assessment
Questions and Answers with 100% Correct Answers | Latest Version
OUTPATIENT CARE SETTINGS AND METHODS OF DELIVERY - (ANSWER)Several factors why physicians
why fewer physicians open their own practice:
· Unknown rapid changes in health care delivery systems
· Contracting with Managed care instead of going solo
· Competition from large organizations
· High Costs to open a new practice
· Complex billing and collections in a multipayer system
· Increased external controls over the practice of medicine
Group Practice offers several benefits: - (ANSWER)· Patient referrals in network
· Leverage in negotiating with MCOs
· Able to take some time off with other colleagues covering your patients
· Higher salaries
Available Profit Sharing
Hospital Outpatient clinics in inner city areas function as: - (ANSWER)· Community Safety Net
· Provides primary care to the uninsured population
· Key profits to many hospitals
· Hospitals have expanded their outpatient department and utilization has grown and are cutting costs.
Hospitals have both inpatient and outpatient services to enhance their revenues. - (ANSWER)For
examples:
· Referring post-surgical cases to its affiliated units for rehab
· Home care follow up
· Patients who receive services that are hospital affiliated are referred back to the hospital for inpatient
care.
Questions and Answers with 100% Correct Answers | Latest Version
What is Outpatient Care/Ambulatory Care? - (ANSWER)Consists of:
· Diagnostic and therapeutic Services provided to walk in patients
· Care for patients who visit physicians, outpatient departments of hospitals
Outpatient Services refer to as: - (ANSWER)· No overnight stay
· Offered at long term care facilities
· Hospitals that offer outpatient surgeries, rehab and specialized clinics
· Basic routine physical exams and minor treatments that are performed in physician office
Advanced outpatient services required are sometimes done at hospitals with outpatient departments
Scope of Outpatient Services - (ANSWER)· Access remains a problem for uninsured and racial/ethnic
minorities.
· Visits are higher in metropolitan areas than in rural areas, reflecting poorer access to primary care in
rural areas
· Outpatient care do much more than primary care services; most surgeries are now performed in
outpatient settings and could be performed at hospitals
· Services shift towards outpatient care and hospital occupancy have declined
· Establishing more Outpatient care market has become a threat to hospitals due to services are
expanding more and has been a competition for medical services between hospitals and community
based providers
Examples of competition: - (ANSWER)· Home health
· Ambulatory clinics for routine services
· Urgent care
· Outpatient surgery
· Dental and optometric services
Changes that have contributed to why there is a shift in balance between inpatient and outpatient
services: - (ANSWER)· Reimbursements
,Chapter 7 What is Outpatient Care/Ambulatory Care? | Assessment
Questions and Answers with 100% Correct Answers | Latest Version
· Technology Factors
· Utilization Controls
· Social Factors
Reimbursement: - (ANSWER)Hospitals have developed outpatient care services to offset the declining
inpatient income because:
· Outpatient care cost less
· MD discharges their patient quicker under prospective and capitated reimbursement.
· These financial factors have provided a major growth of home health care.
Technologic Factors: - (ANSWER)· Less invasive surgical methods and new diagnostic treatment
procedures can be done outpatient that require inpatient hospitals stays
· Less traumatic procedures such as shorter acting anesthetics and minimal invasive technology leads to
shorter recovery times
· Physicians have expanded their capacity to perform outpatient services
Utilization Factors: - (ANSWER)· Inpatient hospitals stays are discouraged by various payors.
· Prior auth for inpatient admissions and minimizing hospitals stays controls costs
Social Factors: - (ANSWER)· Patients would prefer health care in the home and community-based
settings.
· Being home gives individuals a sense of independence.
OUTPATIENT CARE SETTINGS AND METHODS OF DELIVERY
Private Practice - (ANSWER)· Physicians in and office settings form the backbone of ambulatory care.
Provides:
· Limited examinations and testing
· Encounters with doctors in short duration
· Waiting time is longer than the time actually spent with the doctors.
, Chapter 7 What is Outpatient Care/Ambulatory Care? | Assessment
Questions and Answers with 100% Correct Answers | Latest Version
OUTPATIENT CARE SETTINGS AND METHODS OF DELIVERY - (ANSWER)Several factors why physicians
why fewer physicians open their own practice:
· Unknown rapid changes in health care delivery systems
· Contracting with Managed care instead of going solo
· Competition from large organizations
· High Costs to open a new practice
· Complex billing and collections in a multipayer system
· Increased external controls over the practice of medicine
Group Practice offers several benefits: - (ANSWER)· Patient referrals in network
· Leverage in negotiating with MCOs
· Able to take some time off with other colleagues covering your patients
· Higher salaries
Available Profit Sharing
Hospital Outpatient clinics in inner city areas function as: - (ANSWER)· Community Safety Net
· Provides primary care to the uninsured population
· Key profits to many hospitals
· Hospitals have expanded their outpatient department and utilization has grown and are cutting costs.
Hospitals have both inpatient and outpatient services to enhance their revenues. - (ANSWER)For
examples:
· Referring post-surgical cases to its affiliated units for rehab
· Home care follow up
· Patients who receive services that are hospital affiliated are referred back to the hospital for inpatient
care.
