Case Migration: Looking Beyond Clinical Acuity

You are probably asking yourself, “Why is case migration the last topic in this Hospital Ambulatory Strategy Series?” It’s not because determining which cases to migrate isn’t important, it is. But what is far more important is the homework that has to be done to get to this point. For the past several weeks, this article series has focused on aligning the physicians, strategies, incentives, and reimbursement elements needed to build a successful ambulatory program. Once those pieces are in motion, selecting which and when to migrate cases can take center stage. Don’t forget about the how, migrating cases is not just about relocating operating rooms. Ambulatory locations should function differently than hospital locations so there will be lots to consider beyond just the clinical aspects of performing the case.

In this series, we have mapped out the process for identifying an ambulatory need, developing a plan and considerations when going from strategy to execution. Now it’s time to focus on which tactics, service models, and physician champions will best help you achieve your goals. Leaders are engaged in the process, incentives to support a change have been developed, and a reimbursement specialist is engaged to understand the short- and long-term financial implications of the choices made. All of these components are critical to consider, and include, when choosing which cases to migrate and the ideal timing.

To initiate this work effectively, here are a few key questions and considerations when addressing case migration.

Focusing on only one of these critical areas makes it far less likely to have an operationally and financially successful ambulatory location. To achieve success, it is essential to take a holistic approach from the beginning that encompasses all critical aspects, such as patient care, physician engagement, efficient resource utilization, and a robust reimbursement strategy. Neglecting any of these areas can lead to imbalances that undermine the overall effectiveness and sustainability of the ambulatory model.