ABSTRACT

Outpatient clinics provide an important and essential part of the U.S. healthcare system. Being less costlythanmoreintensivepartsofthehealthcaredeliverysystem,suchasinpatienthospitalunits, outpatientclinicsserveasanefficientlocationforlargevolumesofpatientstoreceivecarefromphysiciansandotherhealthcareprofessionals.Byprovidingcoordinationwithotherpartsofthehealthcare system,outpatientclinicscanserveasahuborhomelocationforthemedicalcareofindividualpatients. Reimbursementmechanismscreateuniquechallengesintheoutpatientclinicsetting,mostnotablyby notprovidingfundingforthiscoordinationofcareacrossthecarecontinuum.Revenuesaregenerated byface-to-faceencountersbetweenpatientsandprovidersandofficeprocedures.Ÿispaymentmethodologypromoteshighvolume-lowmarginactivity.Ÿehighvolume-lowmarginconceptiscentralto many issues that provide challenges and opportunities in the outpatient clinic setting.