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The Shift to Outpatient Care
Ironically, as hospital administrators devel- op plans to increase revenue, keeping peo- ple well and out of the hospital is a critical piece of the plan. Why? Hospital overhead is expensive, and studies from the country’s largest health insurers over the last decade have determined that many patients didn’t require all the services and associated ex- penses of a hospital setting for their ail- ments. Medicare and Medicaid, the nation’s largest health insurers, began cutting back insurance reimbursements and penalizing hospitals for readmitting patients within 30 days of discharge. Hospital leaders searched for ways to make up the shortfall while still offering quality care. What they realized was that with equipment becoming more portable and many procedures becoming more routine, they had other means to pro- vide treatment. Those who needed a hospi- tal bed in the past could get their doctoring in another setting.
“The advances in medicine have made it possible to shift more and more health ser- vices from inpatient to outpatient care,” says Anthony Ferreri, executive vice president and chief affiliation officer of Northwell Health, formerly known as North Shore-LIJ Health System. (Phelps Memorial Hospital Center and Northern Westchester Hospital in Mount Kisco recently joined the Northwell family.) “Hospitals and health systems are opening up urgent-care centers, ambulatory services, and medical office buildings. You can go into a building that’s like a medical mall. As we move into ambulatory settings now, the hos- pitals are competing more than ever.”
This trend is evident throughout Westchester. Northwell opened urgent- care centers this winter, in partnership with GoHealth Urgent Care, in both Tarrytown and Yorktown Heights, where patients can check wait times online before heading over. This adds to Northwell-GoHealth’s existing location in New Rochelle, where Montefiore Health System operates the 242- bed Montefiore New Rochelle Hospital, as well as an outpatient clinic. White Plains
Hospital, a Montefiore Hospital partner since 2015, opened a satellite practice, White Plains Hospital Physician Associates, in New Rochelle in 2013. It has also put down roots farther north, with a medical-and-wellness center in Armonk (White Plains Hospital Medical & Wellness), about a 10-minute drive from Northern Westchester Hospital’s ambulatory-care center in Chappaqua. And Phelps increased its physician presence in Dobbs Ferry and Croton-on-Hudson with new and expanded office spaces. (Even more doctors are taking up residence in the county this spring as ColumbiaDoctors, a NewYork-Presbyterian/Columbia University Medical Center medical practice, moves into a 20,000-square-foot space in Tarrytown.)
It may seem like there’s a lot of redundancy of services in a small geographic space, but the New York State Department of Health doesn’t see it that way. The state agency requires hospitals to substantiate the need for medically related building or services in a community. The CON, or Certificate of Need, process gives the state DOH “oversight in limiting investment
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NewYork-Presbyterian/ Lawrence Hospital opened its new, state-of-the-art cardiac-catheterization laboratory last year.