Topic Overview

What are outpatient services?

Outpatient services are medical procedures or tests that can be done in a medical center without an overnight stay. Many procedures and tests can be done in a few hours. Outpatient services include:

• Wellness and prevention, such as counseling and weight-loss programs.
• Diagnosis, such as lab tests and MRI scans.
• Treatment, such as some surgeries and chemotherapy.
• Rehabilitation, such as drug or alcohol rehab and physical therapy.

What are the benefits of choosing outpatient services?

Outpatient services usually cost less, because you don’t need to stay overnight. Staff members at outpatient centers are well trained in the service they provide. Most of the time, these centers specialize in one kind of treatment or procedure. Often all the care you need can be provided in one place.

Who uses outpatient services?

Most people can choose an outpatient center instead of a hospital if the needed service is available. But not all medical procedures can or should be done at an outpatient center.

How can you find the right center?

Your doctor may recommend a center. You can also ask family or friends who have used outpatient services to tell you about their experiences.

To find the right center to provide the service you need, you’ll need to ask some questions, such as:

• Does the center take your health insurance? What costs will your insurance pay?
• Will you get instructions before, during, and after a procedure or test?
• Can you get all the care you need at the center?
• Does your doctor think you may need emergency services during the procedure? Can the center treat your other problems if needed?
• What kind of experience does the staff have? How long has the center been in business? Are the doctors certified to provide the care you need?
• Will the outpatient center staff talk with your doctor and give needed information quickly?
• Is the center clean, organized, comfortable, and private?

How can you know if the outpatient center is trustworthy?

Try to find out all you can about the outpatient center before you use it. It’s a good idea to visit the center before you decide.

Many health and government agencies rate or report on the quality of outpatient centers. Check with your state’s board of medicine or with your insurance company to learn more.

You can also use the Quality Check website from The Joint Commission. For more information, go to www.qualitycheck.org.

Types of Outpatient Services

More and more medical procedures are being offered in qualified outpatient service centers.

Outpatient services are offered in many settings. For instance, medical centers often provide various types of outpatient services, such as pain clinics or rehabilitation centers. Other types of outpatient facilities include:

• Medical group practices.
• Outpatient clinics at hospitals or other medical facilities.
• Surgery centers.
• Imaging centers.
• Cardiac catheterization centers.
• Mental or behavioral health centers, which may provide substance use treatment services and mental health services for adults or children.
• Lab centers.
• Gastrointestinal centers, which may provide screening or other services such as colonoscopy and endoscopy.
• Durable medical equipment rental facilities.
• Physical therapy centers.
• Chemotherapy and radiation therapy centers.

Many outpatient service centers specialize in a specific area of medicine, such as orthopedics (bones) or cardiology (heart). These centers, like many hospitals, have advanced equipment and highly trained staff.

Important Considerations

There are many benefits to outpatient services, depending on the type of medical procedure you need and on what you prefer.

• Outpatient services can be cost-effective. Often, the procedure that you need may cost less at an outpatient service center than at a hospital, especially since you are not billed for separate hospital services. Outpatient service centers do not require an overnight stay. This can reduce costs.
• Outpatient service centers usually specialize in one type of treatment or procedure. And the staff usually has a lot of experience that is focused on the procedure you need. Also, the equipment and techniques used may be the most advanced.
• Outpatient services may be more convenient for you. All of the care that you need before, during, and after the procedure, surgery, or test may be conveniently provided in one place.

When choosing an outpatient facility, consider:

• The reputation and quality of the center. What do you know about the care offered by the facility? Learning about the particular center before the procedure may prevent you from receiving poor care. For more information about finding out the quality of an outpatient facility, see the Quality of Outpatient Services section of this topic.
• The center’s ability to access emergency equipment. Does the center have all of the possible equipment and knowledge it needs to treat you in case of an emergency during your procedure, test, or surgery—such as problems with anesthesia during surgery or your newborn needing intensive care after delivery? If you have other health conditions, you may be at higher risk for needing emergency care.
• The center’s connection to a major hospital, in case you need emergency care, and how far away the hospital is.
• The center’s level of follow-up care. Find out if the center offers follow-up care or designates someone to care for you after the procedure, surgery, or test—even after the center is closed. Will you receive clear, written instructions on how to care for yourself after your visit? Follow-up care can be an important part of appropriate health care.
• The center’s location. Is the facility close enough that if you need to return for additional care, you can get there without too much inconvenience? Is there a center located closer to you that offers the same service?
• The type of communication that will be available to your doctor. Will the facility send all test results and reports to your doctor? If a center does not communicate well, it will be a struggle to get helpful information to your doctor. Talk with your doctor and others who have used the center to find out whether the staff will communicate well with you and your doctor.
• Your insurance coverage. Does your health plan provide coverage for the outpatient service center? If the center is not covered, you risk having to pay more for the services.

Quality of Outpatient Services

Most outpatient service centers are accredited and approved for the types of treatment offered. But not all centers provide care that is right for you. Be sure to find out whether the provider you’re considering is reputable and qualified. The following government and health agencies can help you learn about the quality of outpatient service centers:

• Quality Check, a service of The Joint Commission on Accreditation of Healthcare Organizations. You can contact this organization by phone at (630) 792-5000 or online at www.qualitycheck.org.
• Your state’s board of medicine. Every state in the United States has a state board of medicine that regulates complaints against medical facilities and doctors. Although this agency will not reveal the details about any facility or individual, you can find out if there have been complaints filed against a facility or doctor. You can find your state board of medicine through the local telephone directory. Or go online and search for “Board of Medicine” for your particular state.
• COLA. This group oversees the accreditation for laboratories and testing centers. Information from this agency can be obtained through its website at www.cola.org.
• The American Osteopathic Association. This agency monitors approval of professional services by osteopathic physicians. You can find this agency through your local telephone directory. Or you can find it online at www.osteopathic.org.
• Your insurance carrier. Many insurance carriers keep quality indicator records for doctors and facilities in your local area.

Finding the Right Provider

It is important to check with your health insurance provider to determine what outpatient services are covered. Your particular health plan coverage may limit your choice of services.

Choosing a quality outpatient center before you have a medical procedure is the best way to make sure that you’ll receive excellent care. Friends and family who have used outpatient services may tell you about their personal experiences. Often your doctor will know about the quality of outpatient services in your area. You may want to start your search by talking with your doctor about your options. Next, find out which outpatient services are covered by your insurance company. The following questions may help you find the outpatient service center that best fits your needs:

• Does the facility accept your health insurance? Does your insurance cover any or all of the costs?
• Is the outpatient service center conveniently located or within a reasonable distance of your home or work?
• Is more than one facility in your area qualified to provide the service you need?
• Will the facility communicate well with your doctor and provide the information you need in a timely manner? Can your doctor verify the accuracy of any tests you had?
• Is the outpatient service center accredited by a national medical board or other recognized agency? You can find out by calling your state medical board or The Joint Commission. For more information, see the Quality of Outpatient Services section of this topic.
• Is the facility clean, organized, comfortable, and private? You’ll need to visit the facility to find out. You may want to ask the facility or others who have used the facility if the recovery room is well-staffed. Is there a waiting room for your family?
• Is information readily available to you? Will you receive instructions before, during, and after a procedure or test?
• Are brochures or literature available that explain the outpatient center’s services and fees? Does the facility provide information on financial assistance?
• Do you have other health conditions that should be considered? Can the facility accommodate treating your other conditions if needed? Does your doctor think there is a risk that you may need specialized attention or emergency services during the procedure?
• Can you get all the care you need at the facility? Will the center provide all the medicines or other treatment needed? Will you have to go somewhere else for follow-up care?
• What kind of experience does the staff have? How long has the outpatient service center been operating? What are the specialties of the doctors providing the care? Are they board-certified in their specialty areas?

You may have more questions based on your own health issues and the type of procedure or test you need. Ask questions, listen to the recommendation of your doctor and those you trust, and visit the facility to get the information you need to make the best decision for your health care.