Creating a High-Performing Ambulatory Care Network

By The SHSMD Team posted 11 days ago

A doctor smiles encouragingly at a patient who is seated across from him. As medical care continues to shift from inpatient to outpatient settings, there has never been a more important time for health care organizations to transition to an ambulatory care 2.0 strategy.

“Our vision for ambulatory care at RWJBarnabas Health (RWJBH) in New Jersey is to be the driver of change, innovation and growth for our entire health system,” said Annie Steelman, vice president of system strategy. “We view ambulatory care as the foundation for future sustainability by helping us secure covered lives, manage population health and create preference among consumers by meeting their needs in a retail setting.”

A Tiered Approach
In order to create the right strategy, Steelman said it was critical to identify the distinct levels of care offered by RWJBH in the community.

  • Tier 1 is comprised of traditional entry points such as primary care offices, urgent care clinics and basic diagnostics. The goal was to have these located within a 10–15-minute drive from residents in each area.
  • Tier 2 consists of multispecialty sites and those offering low-acuity procedural care positioned within a 20–30-minute drive from consumers in each region.
  • Tier 3 includes marquee service lines such as interdisciplinary care centers, advanced diagnostics and imaging centers and ambulatory surgery centers located within a 30–40-minute commute.

In order to counter the encroachment of competitors into its service area, RWJBH assessed the services they were offering and where the gaps existed. Steelman then used those findings as well as an analysis of the system’s existing ambulatory services to identify the key issues that needed to be addressed in building a network that drives growth for the system.
The image shows the growth in ambulatory care in US hospitals.

A Work in Progress
RWJBH developed and is in the process of implementing the following key strategies. Early progress, according to Steelman, is encouraging:

System network design. “We needed to ask, ‘Do we have the right mix of services?’ and ‘Is the site an appropriate size?’” said Steelman. “We also need to be regionally visible and distributed to maximize growth potential.” Actions: RWJBH has broadened its urgent care presence in select markets in addition to other services to provide convenient access to patients in each region.

Provider alignment. Part of RWJBH’s overarching medical staff development plan includes finding the appropriate number of primary care providers and specialists for ambulatory care settings. The strategy also requires greater alignment between employed physicians and independent community providers to keep referrals within the system. Actions: To achieve these goals, Steelman said the health system is evaluating and right-sizing physician incentives and using quality and efficiency data to gain strategic insights and develop action plans.

Consumer orientation. Ambulatory networks must be developed to emphasize what consumers value most. “Can they schedule appointments when they need one and can they visit when they want to?” asked Steelman.

Actions: To date, RWJBH has taken steps to strengthen its focus on patient technology touchpoints.

To learn more...

SHSMD members, read the article “Ambulatory Care 2.0: The Next Generation of Network Design and Growth” published in a recent issue of SHSMD’s Spectrum newsletter.

Nonmembers, for more content like this, join SHSMD!

This blog features an interview with:
Annie Steelman
Vice President, System Strategy
RWJBarnabas Health
West Orange, New Jersey