Archived Publications eBook: The Dollars are in the Details | Page 6

Outpatient Care Heats Up
Shifts in volume from inpatient to outpatient care may
be an even bigger obstacle to the CFO’s ability to build
forecasts. Ms. Aquilina suggests many hospitals are not
prepared to address the financial impact of this
inevitable trend.
Like many hospitals, Bethesda has turned to a merger
opportunity to strengthen its position in the market.
To advance their strategy, Bethesda has entered into an
agreement to merge with Baptist Health South Florida, the
largest nonprofit health system in that region of the state.
Baptist Health is an eight-hospital system headquartered in
Coral Gables. It is widely regarded as a hospital leader in
opening urgent care centers, operating about 30 outpatient
and urgent care facilities spanning three counties. In Ms.
Aquilina’s opinion, “The number one reason for the merger
is the need to focus on the outpatient growth side.” The
merger is expected to be complete later this year.
Another challenge she sees is the rise in patients who do not
meet admission criteria, but are placed in hospital beds in an
observation status. Like many hospital systems, Bethesda sees
more and more patients being held overnight for two
midnights who still don’t meet admission criteria. “Unfortunately,
although some people debate this, we provide the same level
of care from a cost standpoint, the same level of nursing care,
whether a patient is admitted to a med-surg bed or placed
in an observation bed,” she elaborates.
To better manage observation patients, Bethesda has
established a dedicated unit. In some cases, Ms. Aquilina
states,