HEALTH POLICY

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For our second Discussion we will be focusing on trends on outpatient services. The Discussion is worth 25 points and is due Monday, March 7th. Remember to to post on two different days. This Discussion will also require at least one reference source beyond the two articles below. To ensure you capture all the possible points review the grading rubric 

Below are two articles, the first from Becker’s Healthcare was drafted in 2010 and the second from Deloitte Insights was drafted in 2020. 

Read both of the articles. Select a topic that interests you and briefly summarize the issue. Then by doing additional research add more detail and perspectives to the topic you selected. You may want to talk about how the topic has changed from 2010 to 2020. Is this and issue that more recently came up (virtual healthcare), or maybe something was a big deal in 2010 that has faded into the background. Finally add your own personal thoughts on the subject. You may wish to talk about trend you personally observe that are not discussed in these articles. 

Basically, talk about anything you want that is contained in one or both of these articles. Just make sure you do some additional research beyond the two articles I posted to support your post. An additional source is required (5 point deduction for not using, citing and referencing an additional source). As always, cite and reference all your sources – including when you use the two articles above. 

You can talk this discussion in many different directions, and it is a broad topic. So, dig in and have fun with this. 

REPLY BACK TO THESE TWO POSTS 

Outpatient services are utilized now more than ever before. Insurance providers such as Medicare have contributed to this shift with their two-midnight rule as well as implementing new criteria for in-patient eligibility (Gerhardt & Arora, 2020). Hospitals are now incentivized to reduce the number of nights a patient stays and are required to admit patients who wouldve been considered in-patient as observation status with outpatient billing. Working at Saint Mary Hospital, I notice that providers try to avoid admitting patients as observation status because there is essentially little to no reimbursement for the hospital.

Compared to 2011, when inpatient revenue exceeded that of outpatient, the outpatient revenue in 2018 is almost converging with inpatient revenue indicating a higher utilization of such services (Gerhardt & Arora, 2020). In addition to new requirements by insurance companies, the shift to outpatient utilization can also be credited to technological advances which makes outpatient services much more accessible than inpatient services. Coronavirus restrictions provided such technological medical advancements the chance to grow which I think may not have happened otherwise. Advances such as tele-health have encouraged patients, including myself to utilize preventive services which prevents the need for future hospital admission. In fact, one study found that tele-health options actually reduced hospital admissions by 19% (Dinesen, et al., 2016).  I think that the emphasis on outpatient services is important because less patients are going into the hospital where they could be exposed to other diseases. Additionally, outpatient services are especially valuable because the practice focuses on preventing disease whereas in-patient services focus on addressing an established health issue.

AND THIS ONE 

One topic that interests me involves the issue of revenues for outpatient services being under pressure. This comes as a result of the erosion of independent medical practices, which will decrease the rate of case numbers and put pressure on revenue involving outpatient services (Becker & Kirchheimer, 2022). Reimbursements for services will experience serious pressure, however the hospital and pharmaceutical industries are somewhat protected from reimbursement risk due to the fact that they secured a large section of the healthcare budget (Becker & Kirchheimer, 2022). According to the article, Outpatient and Virtual Healthcare from Deloitte Insights, its mentioned that health systems have been moving more towards outpatient care, with outpatient revenue growing 9% between 2011-2018 and the total revenue for outpatient services growing from 28% in 1994 to 48% in 2018 (Gerhardt & Arora, 2020). From this, its clear that revenue for outpatient services has increased over the years, in addition to almost equaling inpatient revenue and could potentially surpass it in the years to come. According to the article, Outpatient Revenue Outpaces Inpatient Revenue, its mentioned that the transition towards outpatient care and increasing revenue for outpatient services is the result of technological advancements, reimbursement drivers, and patient preference as it is more convenient and involves lower out-of-pocket costs (Bailey-Wheaton, 2020). A potential solution to reduce revenue for outpatient services being under pressure would be to have healthcare providers lower the costs of services provided to patients (Becker & Kirchheimer, 2022). I believe that this would lower the pressure on revenue for outpatient services because lowering costly services would definitely improve patient satisfaction and likely attract more patients to receive those types of services. 

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