- In a survey of 183 C-suite hospital executives, the primary concern (57%) was improving patient access to ambulatory or outpatient settings, Advisory Board Company found.
- Following outpatient access, executives were concerned about expense reduction (57%), boosting outpatient procedural market share (55%), minimizing unwarranted clinical variation (54%), and controlling avoidable utilization (49%).
- A year ago, minimizing unwanted variation in care cost and quality topped the field at 53%. This year, controlling avoidable utilization of care resources held steady at fifth.
While the sample size of the study was relatively small compared to the presumed C-suite executive positions in the 5,564 registered hospitals that American Hospital Association recognizes, the results of the survey make complete sense as care slightly moves away from hospitals and individuals entertain telehealth and low-acuity primary care options.
Overall, the changes in interest point to hospitals and health systems increasingly seeing their relationships with physicians as potential points of differentiation from other providers in their communities, according to Advisory Board. "The uncertainty on timing and specifics of the repeal of the ACA, as well as MACRA, are creating more momentum from physicians to seek support and alignment with health systems," said Lisa Bielamowicz, MD, Chief Medical Officer and SVP, Research at Advisory Board. "While demand for physician employment is at a near-record high, hospitals should use this moment to refocus their physician strategies on building a network centered on delivering accessible, lower cost and reliable healthcare. This will advantage systems regardless of the specifics of payment reform."
With data playing the devil's advocate, it makes sense why hospital executives are looking to expand outpatient and ambulatory opportunities. Hospital utilization as well as hospital beds are on the decline while expenses are rising. ABC's analysis of using provider relationships as a differentiator slightly acknowledges that the hospital-physician power relationship is going back and forth. While some physicians are seeking employment in hospitals, others are leaving hospitals to pursue less stressful jobs such as telehealth and/or consulting opportunities.
Either situation underscores the need for physician burnout to be addressed. If hospital executives are looking to get a piece of the outpatient pie whether through partnerships or acquisitions as well as leverage providers as a differentiator, both scenarios presume an importance on the provider-patient relationship in addition to ease of access. If providers are overworked or hard to reach, then such efforts may come up short.
The survey did not mention how executives intend to reach these goals but solutions such as telehealth or partnering with, opening or buying a primary care clinic are only a couple of options to achieve their goals. It will be interesting to see how the space has moved toward the end of the year.