Hospitals' outpatient revolution: 5 leaders' thoughts 

Becker's asked 37 C-suite executives from hospitals and health systems across the country to discuss their outpatient strategy.

Here's what five of them had to say about ambulatory surgery strategy:

Rob Bloom. CFO of Carthage Area Hospital (N.Y.): Outpatient growth is a key component of our strategy. Compared to 2019, outpatient revenue has grown by 25 percent and is now arguably the primary relationship with the community we serve. Outpatient revenue now accounts for 90 percent of the total revenue of the hospital. This growth has been driven by investments in primary and specialty care, as well as lower cost-of-care settings, such as an ambulatory surgery center. Moving forward, a key strategic driver to navigate this environment is a focus on ensuring that the finance, quality, and clinical functions of the hospital are working collaboratively to deliver value to the community. 

Michael R. Canady, MD. CEO of Holzer Health System (Gallipolis, Ohio): We are fortunate that our decade-old merger created a natural business model heavily focused on our ambulatory practice. The majority of our revenue results from our ambulatory business. The cost of acute care will continue to drive patients to ambulatory settings, when possible.

Howard Haronian, MD. Vice President, Chief Quality and Innovation Officer of Hartford (Conn.) HealthCare: Hartford HealthCare is on a mission to be the caregiver of choice for personalized coordinated care. That requires a pivot of focus from hospital acute care to delivering the highest quality care close to home. To support the patient in the most convenient and cost-effective manner, we have invested in state-of-the-art comfortable ambulatory offices across two states. We create multispecialty clinics with embedded onsite services including imaging and lab testing. 

Second, we embrace technology that allows us to deliver expertise throughout our ambulatory footprint, reducing reliance on the traditional spoke-hub model. One example is our Heart & Vascular Institute developing a system-wide approach to remote monitoring of heart failure patients, and optimizing enterprise cardiac PACS to support advanced cardiac imaging with our expert cardiologists reviewing at a distance. Third, our ambulatory strategy includes a coordinated systemwide approach to RPM led by clinicians across key specialties.

Paul Hinchey, MD. COO of University Hospitals (Cleveland): At University Hospitals (UH), we fully embrace the move to value in healthcare – providing the highest quality care at the lowest possible cost to the patient while at the same time optimizing efficiency for patients, providers and payers. Crucial to this goal is creating an effective system of care that provides patients with a wide range of outpatient access options, effectively meeting them on their own terms.

We also continue to increase the utilization of our existing ambulatory surgery sites while expanding our offerings. In 2022, we broke ground on a state-of-the-art surgery center with five operating rooms and one procedure room, focusing predominantly on orthopedic surgical procedures and including spine, ENT and pain management services.

Arshad Rahim, MD. Chief Medical Officer and Senior Vice President of Population Health at Mount Sinai Health System (New York City): Our strategy is supported by substantial investments in our ambulatory offering and footprint:

  1. We are increasingly focused on home-based interventions whether that is remote patient monitoring for chronic conditions and other home-based offerings such as hospital at-home and palliative care at home. Increased virtual offerings including virtual urgent care and virtual primary care. 
  2. Bolster and further empower our primary care provider base. Invest in a team-based care model and optimize ambulatory EMR functionality. 
  3. Invest in ambulatory surgery center ownership.

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