Question

2-3 factors that are responsible for inpatient growth.

Answer 1

# Hospitals with greater revenues from quality and value contracts provided more outpatient services than other hospitals. Hospitals that derive a large part of their revenue from quality and value contracts had 21 percent more Medicare outpatient visits and 13 percent higher outpatient revenue between 2012 and 2015 compared with hospitals that did not report revenue from such contracts.

association between having these contracts and higher outpatient services was even more pronounced for certain therapeutic areas. The relationship was strongest for major diagnostic categories with higher rates of physician-hospital affiliation and technological change. Outpatient revenue was 18 percent higher for diseases of the circulatory system5 and 13 percent higher for diseases of the musculoskeletal system6 among hospitals with large incentives.

All hospitals saw declines in inpatient revenues, but hospitals with greater revenues from quality and value contracts did not see steeper declines than other hospitals. The lack of a relationship between quality and value contracts and inpatient care may be because health systems are not yet at sufficient risk to actively manage population health to reduce inpatient care more aggressively.

Human and physical capital. Expanding outpatient services may call for additional physical and human capital and workflow and operational improvements. Building physician relationships and networks through partnerships or affiliations can help build capacity and attract patients.

Virtual care/technology. Investing in virtual care capabilities could expand outpatient services while also helping hospitals bend the cost curve and boost revenue.

Case management. Health systems can work with physicians to use analytics and with patients to decide on which care setting is the most effective, safe, and efficient.