Ambulatory Services Frequently Asked Questions
What analysis should be completed before opening or expanding an ambulatory site?
Examine market opportunity, access, provider capacity, reimbursement, and financial feasibility together. Provider needs assessment, access-point analysis, and hospital outpatient department-to-freestanding rate comparisons can help define the proposed site’s role and the requirements for implementation.
What should due diligence cover in an ambulatory transaction or joint venture?
The scope can extend beyond financial statements to reimbursement, operations, compliance, technology, and integration needs. Financial due diligence and reimbursement differential analysis should reflect the transaction structure and the questions the parties need to resolve.
How can an ambulatory organization assess day-to-day performance?
Review operations, revenue cycle performance, patient- and family-centered processes, and coordination across sites of care. Considering these areas together helps leaders relate the findings to financial performance, patient experience, and the broader delivery system.
When should an ambulatory arrangement be evaluated for fair market value?
Valuation analysis may be appropriate for arrangements involving management fees, gainsharing, block leases, physician compensation, professional services, or real estate leases. The scope of the analysis should reflect the structure, terms, and specific facts of the arrangement.
What compliance and technology issues should ambulatory organizations evaluate?
Ambulatory organizations should evaluate coding, documentation, medical necessity, clinical documentation improvement, regulatory compliance, cybersecurity, and security risk management. Telehealth solutions and artificial intelligence deployment may also require careful planning as the organization expands or changes how care is delivered.
