Why Acute Healthcare Services Are Moving To Ambulatory Care Centers
There are a myriad of reasons healthcare services are moving out of hospital settings to freestanding, ambulatory care centers (ACCs), but Rendina Healthcare Real Estate SVP of business development and leasing Neil Carolan tells Bisnow it all boils down to quality and cost of care. Neil will be one of the healthcare real estate experts presenting at Bisnow's Orange County Healthcare Expansion Forum on Thursday at the Hyatt Regency Orange County.
Neil's company is a national developer of ACCs and medical office buildings (MOBs). Above is Tucson-based Neil, right, and Dallas-based Gant Braley, both Redina SVPs for business development and leasing, accepting the 2015 Healthcare Real Estate Insights magazine award for Rendina’s 22k SF Carolina Coast Surgery Center. The center captured the award for "Best New Medical Office Building or Other Outpatient Facilities of Less than 25k SF.” Serving a two-county area, this facility (below) provides comprehensive orthopedic and pain management services, cost-effective surgery and physical therapy.
Due to new reimbursement rules and policies established by the Centers for Medicare & Medicaid (CMS) and now adopted by some private insurers, healthcare providers are being paid based on value-based outcomes. When procedures are done on an outpatient basis, outcomes are often better, Neil tells us. If a patient is readmitted to a hospital within 30 days of a previous hospital stay for the same diagnosis, CMS will not pay the hospital for the readmission, he adds.
Neil understands why insurers are driving care to ACCs, as he was a senior-level healthcare executive for nearly 30 years before joining Rendina. “People get sicker in hospitals,” he says, noting the threat of hospital-acquired infections, which result in about 99,000 deaths annually, according to the Centers for Disease Control and Prevention. Such infections are far less prevalent in ACCs, the care is more cost effective, patients like it and they heal quicker at home, Neil explains.
He credits advances in medical technologies for making it possible to provide better outcomes and value in outpatient settings. For example, Siemens makes a Interoperable CT scanner that travels on a track between a number of OR suites, so rather than having to move patients, the technology comes to them.
Normally surgical procedures done in an an ACC take less time due to the nature of the procedure, and turnover time of the operating suite is a fraction of turnover time of a hospital OR, he says.
MOBs, ambulatory surgery centers (ASCs) and other ambulatory centers are less expensive to build than hospitals, but Neil tells us new CMS regulations on reimbursement state any facility more than 250 feet from an acute care facility will receive reimbursement at a lesser level than the same procedure done in a hospital. There are some exceptions, and this new ruling does not include ASCs, which normally have their own rate structure.
Historically, MOBs were filled with physician offices. Over the last few years, services provided in MOBs have changed significantly, Neil says, and may include imaging centers, long-term acute care and rehab facilities, and ASCs—the majority of ASCs are freestanding facilities.
“Overall, the Affordable Care Act provided care to a much larger population in need of care," Neil says. “It provides healthcare to a whole group of people left out before, and uses more ambulatory facilities than ever before.”
Hear more from Neil and other healthcare real estate professionals at Bisnow's Orange County Healthcare Expansion Forum on Thursday, beginning with networking and breakfast at 7:30am, at the Hyatt Regency Orange County, 11999 Harbor Blvd in Garden Grove. Sign up here!
