Ambulatory Care: A Case Study

In chapter 5 we have reviewed major elements of ambulatory (outpatient) care and discussed changes supported by the Patient Protection and Affordable Care Act (ACA) and American Reinvestment and Recovery Act. Ambulatory care encompasses a diverse and growing sector of the healthcare delivery system. Ambulatory surgery is a continuously expanding component of ambulatory care, as new technology allows an increasing number of procedures to be performed safely and efficiently outside of the hospital. In addition to new diagnostic and treatment tools available in outpatient setting, financial mandates also have driven services into the ambulatory arena. This new development pushed more hospitals to shift procedures and services amenable to outpatient delivery from more expensive inpatient environment to less expensive. For profit, free standing facilities providing primary, specialty, and surgical services have been increased (Sultz & Young, 2014, p163-199).
With the implementation of ACA and accompanying increase of new care delivery models such as patient-centered medical homes
The way physicians organize and operate their private practices has evolved from variety of factors. The American Medical Association (AMA) had long opposition group practice model finding salaried physician were unethical. After many confrontations, physicians pursued participation in developing group health plans. After 1950, due to changing economics and lifestyle caused most physicians to group together and was followed by a significant increase of medical knowledge and new technological advances. Significant change of private medical offices occurred after introduction of Medicare reimbursement in 1966, due to more complex government regulations and billing requirements (Sultz & Young, 2014,