Texas State Health Plan: 1987-1988 Page: 59
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CHAPTER VIII
SHORT-TERM
INSTITUTIONAL CAREPRIORITY Development of alternative delivery methods by
ISSUE hospitals.
PROBLEM STATEMENT: To lessen costs and increase accessibility of
health care services, hospitals and other providers should develop alter-
native delivery methods and provide information to the public regarding
the availability and benefit of such services.
BACKGROUND AND POLICY ANALYSISAs the costs of medical care have increased, both
public and private payers of the state's health care bill
have begun to look for less costly ways to provide
such care, especially by hospitals which use 41% of
the health care dollar (Figure A). Many alternatives to
the traditional costly methods of providing care in
hospitals have been developed. These outpatient
services can be grouped under the term alternative
ambulatory care.
Ambulatory care facilities refer to those facilities and
organizations, either hospital-based or free-
standing, that provide home health care, outpatient
surgery, urgent and emergency care, outpatient
rehabilitation and therapy, preventive health and
fitness programs, hospice care, less than 24-hour
care, and other diagnostic and therapeutic services
to outpatients. Several factors tend to promote the
development of alternative delivery methods by hos-
pitals. The Medicare prospective pricing system, for
most hospital services, provides incentives to deliver
hospital care in a cost-effective manner. Competition
from alternative health plans and other providers
necessitates further development of cost-effective
health care. Hospitals will lose their market share if
they can't offer competitive prices for the same
services.1 Technological advances increase the
range of health care available in an ambulatory
setting. Insurance coverage is changing to encour-
age use of ambulatory care.
Nationally, most free-standing alternative health care
facilities are being developed by single hospitals and
small groups of physicians. Approximately 80% ofTexas hospitals have already initiated or are planning
alternative delivery programs. The remaining 20%
are mainly small rural facilities of less than 100 beds
(Figure A).21987-88 TEXAS STATE HEALTH PLAN
4i:
FIGURE A
THE NATION'S HEALTH DOLLAR IN 1984
Research,
Construction,
Administration,
12e
Other
Health Care Hospital
Goods and Care
Services 41 iz
20;
Physicians
Services Nursing
191 Home
Care
Where It Went
SOURCE: Health Care Financing Administration59
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Texas. Statewide Health Coordinating Council. Texas State Health Plan: 1987-1988, report, 1986; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth1586615/m1/71/: accessed July 16, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.