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Health Care Sample Questions

Question

Answer the two discussion questions below and note references:

1, What legal issues are unique to ambulatory care centers? What is the impact of these issues on ambulatory care center management?

2. In what ways are ambulatory care centers reimbursed? Explain the differences in reimbursement between ambulatory care centers and traditional hospitals?

Answer

Ambulatory Care Centers

Question 1

Ambulatory care centers also known as outpatient centers, are medical facilities that offer or provide care to patients that does not require overnight admission (Ruchaber & Tormoehlen, 2010). Some legal issues unique to ambulatory care centers include the Health Insurance Portability and Accountability Act (HIPPA) and antitrust issues with joint-venture managed care contracting.

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Some new amendments made to HIPPA include the tracking of the portable devices that store protected health information and the patients’ right to be given their medical records with little pay (Scott & Fields, 2011). These amendments have not only led management of the surgery centers to incur more costs, especially with the provision of medical records, but with the tracking of the portable devices.

On the other hand, anti-trust issues come about during determination on whether it is possible for physicians to sign a joint contract in order to acquire better rates from payors, thus, avoiding conspiracies against each other according to the antitrust laws (Scott & Fields, 2011). Such anti-trust issues translate to high costs in ambulatory care management in terms of time and expenses channeled towards the most suitable hospital.

Question 2

Ambulatory care centers are reimbursed according to the requirements of the Outpatient Payment System (OPPS) which has a predetermined set of payment procedures for each surgical package depending on the surgical procedures involved and the incidental and technical costs incurred during and after the surgery (Guidi, 2016).

The main difference between the ambulatory care centers’ reimbursement rates and those of traditional hospitals is that those of the former are usually updated annually depending on the inflation at the time and are generally higher while those of the latter are often pre-determined and are generally lower (Guidi, 2016).

References

Guidi, T. U. (2016). Medicare’s Hospital Outpatient Prospective Payment System. Journal of Oncology Practice7(1), 57-60.

Ruchaber, J. & Tormoehlen, K. (2010). Key trends in the valuation of ambulatory surgery centers. SurgiStrategies, April 2010.

Scott, B., & Fields, R. (2011) Six Key Legal Issues Facing Ambulatory Surgery Centers. Becker’s Hospital Review. January 12, 2011.

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