Procedures and surgeries once only performed in hospitals are now being done in ambulatory care settings through the expansion of services. Ambulatory care services include: primary care visits, pediatricians, obstetrics and gynecological visits. There are a variety of care options when discussing ambulatory (outpatient) care. Private practice visits are short, examination and tests are limited. Freestanding facilities: walk-in clinics, urgent care centers some which can be found in CVS or Walgreens. Mobile facilities providing services such a mammography, x-ray, dental care, and optometric care. Telehealth is becoming popular: patients can call and speak to a medical provider to get advice during off peak hours. Hospice care is provided to terminally ill patients. Many hospitals have developed outpatient clinics that are primarily located in most inner-cities allowing for easier access for care and testing. There are five types of hospital based outpatient clinics: (1) clinical: used by those who are uninsured or may be participating in research studies, (2) surgical: patients may have same day surgeries and discharged to home, (3) home health care: patient may receive medical services at home after being discharged from the hospital or rehabilitation, (4) women’s health, and (5) emergency centers. Free clinics provide medical services for those who do not have …show more content…
The Social Security Amendments of 1983, required Medicare to change how hospitals were paid for services (Shi, 2018). Instead of per diem rates being paid to hospitals, prospective payment system was developed. Hospitals are now being reimbursed based on diagnoses on a pre-established fixed rate per admission and some being penalized for readmissions of the same diagnosis with in a 30 day period. Inpatient care facilities face many challenges in the delivery of care to patients due to the Affordable Care Act and Medicare/Medicaid reimbursement. There challenges have opened the door for outpatient care facilities under inpatient care facilities. The growing trend for services outside of the inpatient hospital settings are growing day by day, being shown by the expansion in services such as outpatient rehabilitation, telehealth, alternative medicine, home care, and hospice