Ambulatory Services Frequently Asked Questions
What analysis should be completed before opening or expanding an ambulatory site?
PYA’s ambulatory strategy services include financial forecasting, feasibility studies, hospital outpatient department to freestanding rate analysis, access point analysis, provider needs assessment, provider network strategy, and service line planning. Together, these areas address market opportunity, access, reimbursement, provider capacity, and financial viability.
What should due diligence cover in an ambulatory transaction or joint venture?
PYA’s ambulatory transaction services include financial due diligence, comprehensive due diligence through SCOUT, black-box reimbursement differential analysis, merger and acquisition support, joint ventures, affiliations, and post-transaction integration. The scope can therefore extend beyond financial statements to reimbursement, operations, compliance, technology, and integration needs.
How can an ambulatory organization assess day-to-day performance?
PYA identifies operational assessments, revenue cycle performance improvement, patient- and family-centered strategies, and alignment across the care continuum and sites of care. These areas help connect ambulatory operations with 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.