What are the biggest challenges in converting hospital outpatient departments to freestanding facilities?

Issues include regulatory hurdles, reimbursement differentials, capital cost, licensing, payer contract changes, and achieving operational scale. PYA performs market and regulatory feasibility and builds execution roadmaps.

How can a health system expand ambulatory access in rural or underserved areas?

Through access point analysis, telehealth deployment, partnerships with local providers, and optimizing provider network alignment. PYA helps model return on investment, reimbursement risk, and integration plans.

What compliance and coding risks should ambulatory practices monitor?

Misclassification between facility vs. non-facility settings, documentation gaps, medical necessity denials, and regulatory audits. PYA conducts coding audits, documentation improvement (CDI), and readiness reviews.

How does PYA support outpatient partnerships and joint venture deals?

We conduct diligence, model revenue-sharing, analyze reimbursement differentials, structure governance, and manage integration to ensure deals promote aligned incentives and successful outcomes.

Ambulatory Services

PYA helps organizations develop and successfully execute ambulatory care strategies to improve access and succeed under value-based arrangements. Our experience and expertise include the development, operations, and expansion of hospital outpatient departments, freestanding emergency departments, ambulatory surgery centers, imaging centers, urgent care centers, telehealth services, and multi-purpose ambulatory care centers.

Our Services for Ambulatory Care Providers

Financial Forecasting and Feasibility Studies
HOPD to Freestanding Rate Analyses
Ambulatory and Service Line Strategic Planning
Access Point Analysis and Expansion
Provider Needs Assessments
Provider Network Strategy
Alternative Payment Model Participation

Mergers and Acquisitions
Joint Ventures & Affiliations
Black-Box Reimbursement Differential Analyses
Quality of Earnings Assessments
Due Diligence—PYA SCOUT
Post-Transaction Integration

Operational Assessments
Revenue Cycle Performance Improvement Initiatives
Patient- and Family-Centered Strategies
Alignment Across Care Continuum and Sites of Care

Coding, Documentation, and Medical Necessity Reviews
Clinical Documentation Improvement (CDI)
Regulatory Compliance

Management Fees
Gainsharing Arrangements
Block Lease Arrangements
Physician Compensation
Professional Service Arrangements
Real Estate Lease Arrangements

Cybersecurity
Security Risk Management & Compliance
Telehealth Solutions
Artificial Intelligence Deployment

Portfolio Management
Identification and Execution of Space Consolidation and Optimization

Audits, Reviews, and Compilations of Financial Statements
Forensic Accounting and Dispute Resolution
Accounting Policies and Procedures Implementation
Internal Controls Assessment
Fractional Accounting Support
Purchase Price Allocation

Federal, State, and Local Income Tax Returns
Representation During IRS, State, and Local Examinations

From Access to Execution: Ambulatory Done Right

Title: Ambulatory Services & Outpatient Strategy Advisory | PYA

Strategic Ambulatory Planning

Ambulatory growth often fails without data-backed strategy. PYA helps assess market opportunity, evaluate HOPD-to-freestanding shifts, forecast financial viability, and build provider network strategy to support sustainable growth.

Transactional & Partnership Structuring

Whether it’s M&A, joint ventures, or affiliations, PYA delivers due diligence, reimbursement differential analyses, integration planning, and deal structuring that align incentives and mitigate risk.

Performance, Compliance & Integration

We ensure day-to-day success via operational assessments, revenue cycle optimization, clinical documentation reviews, and regulatory compliance support. Plus, we align ambulatory services with broader system goals across care settings.

The PYA Difference

Over our 40-year history, PYA has consistently delivered high-value advisory services to our national client base. Our team is deployed to develop custom plans using proven approaches and work plans.

Independence

Private ownership means we answer only to our clients, not to third-party investors, giving us the freedom to be thorough and thoughtful in our work. We judge our success by our clients’ success.

Relationships

We value long-term relationships and work hard to maintain them. Our commitment to client relationships and the communities we serve remains constant.