Ambulatory Care Organization, Operations & Financing
ECG brings expertise in ambulatory care strategic and business planning, as well as financial and operational analysis, in the context of the tripartite mission and the relationships that exist in AMCs.
ECG works with AMCs in the following areas specific to ambulatory programs:
- Provider-Based Analysis – Determining whether to structure an outpatient clinic as a provider-based (also known as hospital-based) or freestanding entity. ECG is considered a national expert on this topic and has presented in several AAMC forums and regularly publishes articles on the subject.
- Program Planning/Strategic Growth – Planning for expansion of existing programs/sites or future satellite strategies to more effectively meet patient needs and support hospital and school of medicine (SOM) strategic goals.
- Ambulatory Funds Flow – Ensuring that funds are available and incentives are aligned to promote ambulatory growth and stewardship of resources.
- Operational Improvement – Enhancing patient service by improving operational efficiencies.
- Physician Compensation – Structuring competitive physician compensation that is aligned with ambulatory care program goals.
- Joint Ventures/Joint Initiatives – Designing and implementing joint ventures that balance the needs of all participants and achieve the goals set for them.
Selected Projects
Improving the operations and financial performance of ambulatory clinics. Expand Minimize
We assisted a pediatric FPP with improving the operations and financial performance of its ambulatory clinics. The scope of our assistance included identifying and implementing changes to the oversight and management structure of the ambulatory clinics, developing performance metrics and expectations, and redesigning financial arrangements around performance. This engagement resulted in a multimillion-dollar turnaround in the next fiscal year.
Evaluating provider-based arrangements. Expand Minimize
The choice of freestanding or provider-based (also known as hospital-based) designation for ambulatory clinics is commonly debated in academic settings. Our approach to evaluating this issue typically includes first assessing the potential reimbursement advantage and then clarifying incremental costs associated with provider-based status. We then assist our clients in determining the most appropriate funds flow model and management structure, through which the objectives of the SOM, hospital, and faculty may be fully aligned. We have experience in evaluating provider-based clinics, and we have assisted multiple AMCs throughout the country. We regularly serve as faculty for programs related to this topic.
Planning for a new ambulatory facility. Expand Minimize
We assisted a large AMC in the Midwest with evaluating the feasibility of a new ambulatory facility. Our scope included incorporating physician growth plans, clarifying future trends, and working with facilities-planning professionals to determine the sizing, programmatic nature, and financial feasibility of the new building.
Developing an ambulatory outreach strategy. Expand Minimize
An AMC with regional growth goals asked us to assist in the strategic and business planning process. We initially performed specific market assessments to determine the areas of greatest demand and need and then completed business planning for multiple sites, including growth projections, a specific services plan, and physician needs analysis. We also assisted in developing arrangements with the SOM FPP to support the start-up period of operations.
