And there’s more outpatient growth on the horizon,
including several physician practice acquisitions in key
markets and even conversion of some inpatient hospitals
into outpatient destination centers.
Much of Trinity Health’s strategy comes down to main-
taining network adequacy, says Nordlund. “You have to have
sufficient access points across your market and the right
kind of levels of care, from the more traditional inpatient
space through the outpatient ambulatory as well as post-
acute spaces in order to care for a population.”
Trinity Health is far from alone in its quest to improve
population health through outpatient growth. That was
among the top factors driving outpatient strategies, cited
by 43% of HealthLeaders Media Ambulatory and Outpatient Care
Other priorities for outpatient expansion included improving quality outcomes (52%), expanding market
share (50%), increasing revenue (48%), responding to
consumer-driven trends (43%), and reducing costs (39%).
Understanding physician organizations
To achieve these goals, roughly half of the leaders
surveyed reported partnering with, acquiring, or establishing
physician organizations. But doing so isn’t necessarily simple.
Nordlund says he learned many lessons throughout Trin-
ity Health’s outpatient expansion, but the need to appreciate
the uniqueness of each setting is one that stands out. “The
expertise that it takes to run and have well-managed acute
operations—those skills don’t necessarily translate to what it
takes to run a network of care,” he says. It requires “learning
new skills in terms of how to put together real-estate deals,
how to acquire physician practices in a meaningful way,
and how to aggregate those practices into well-performing
For health systems, the trick is to assess outpatient
opportunities in a strategic, proactive manner, rather than
a reactive one, says James F. Kravec, MD, FACP, executive
vice president and chief clinical officer for Mercy Health
Youngstown, an integrated health system employing more
than 6,000 and serving four counties in Northeast Ohio.
MHY is one of eight regions of Mercy Health, a 23-hospital
health system serving Ohio and Kentucky, with assets of $6.1
billion and net operating revenue of $4.5 billion.
12 HealthLeaders n July/August 2016
To thrive in today’s healthcare marketplace, hospital and health system leaders need to think beyondputting“headsin beds.” For some, fulfilling the goal of providing patients with the right care at the right place at the right time means becoming virtually
omnipresent in the daily lives of consumers and potential
Expansion of ambulatory and outpatient care networks
makes sense for several reasons, including the desire to improve
patient access, strengthen patient-provider relationships, and
increase revenue. In fact, 84% of healthcare leaders who responded to the 2015 HealthLeaders Media Ambulatory and Outpatient Care
Survey regard the industry’s shifting focus from acute to ambulatory care as an opportunity rather than a threat.
This figure is indicative of a changing mindset among
health executives about outpatient business, including
ambulatory and postacute care.
“Historically, we have viewed ambulatory and postacute
care as means to support hospitals,” says Scott Nordlund,
executive vice president for growth, strategy, and innovation
at Trinity Health, a Livonia, Michigan–based not-for-profit
with facilities in 21 states and annual operating revenue of
about $15.9 billion.
“As we wade into the world of population health
and begin to think about networks of care—including outpatient ambulatory networks—in many cases, we’re investing as much there as we are in our inpatient facilities.
Not everything is necessarily centered around the hospital,”
Maintaining network adequacy
Redrawing one’s circle of influence can happen by several
means—through acquisitions, partnerships, building new
facilities, and often through some combination thereof.
From there, the possibilities are almost endless, encompassing every type of outpatient care from extensivist clinics to
walk-in care to telehealth.
To that end, Trinity Health has recently completed several
projects to bolster its outpatient presence, including a network of freestanding emergency departments, an integrated
medical fitness facility in Ohio, the acquisition of home health
agencies throughout the United States, and more.
“As we wade into the world of population health and begin to think about
networks of care—including outpatient ambulatory networks—in many cases,
we’re investing as much there as we are in our inpatient facilities.
Not everything is necessarily centered around the hospital.”