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Outpatient/Ambulatory Health Services

Outpatient/Ambulatory Health Services

HRSA Service Definition

Outpatient/Ambulatory Health Services are diagnostic and therapeutic services provided directly to a client by a licensed healthcare provider in an outpatient medical setting. Outpatient medical settings include clinics, medical offices, and mobile vans where clients do not stay overnight. Emergency room or urgent care services are not considered outpatient settings.

Allowable activities include:

  • Medical history taking
  • Physical examination
  • Diagnostic testing, including laboratory testing
  • Treatment and management of physical and behavioral health conditions
  • Behavioral risk assessment, subsequent counseling, and referral
  • Preventive care and screening
  • Pediatric developmental assessment
  • Prescription, and management of medication therapy
  • Treatment adherence
  • Education and counseling on health and prevention issues
  • Referral to and provision of specialty care related to HIV diagnosis

Program Guidance:

Treatment Adherence services provided during an Outpatient/Ambulatory Health Service visit should be reported under the Outpatient/Ambulatory Health Services category whereas Treatment Adherence Services provided during a Medical Case Management visit should be reported in the Medical Case Management service category.

As part of Outpatient and Ambulatory Medical Care, provision of laboratory tests integral to the treatment of HIV infection and related complications.

Number of Clients Served, Units Provided, Expenditures,* Allocation*, and Over/Under-spending

Year 2016 2017 2018 2019 2020 2021 2022
Medical Care Clients 11,011 11,176 11,056 11,617 10,848 11,078 10,911
Medical Care Units (Dr. visit) 38,850 35,662 36,606 35,511 32,003 21,838 30,205
Medical Care Dollars $7,227,633 $7,104,406 $7,362,705 $7,328,009 $6,786,955 $6,874,190 $6,847,595
Allocated Dollars $7,152,427 $7,162,288 $7,055,207 $6,952,646 $6,915,452 $6,900,099 $6,965,625
Over/ Underspending $75,206 over $57,882 under $307,498 over $375,363 over $128,497 under $25,909 under $118,030 under

*Includes Minority AIDS Initiative (MAI) funding

Funding by Part, and info on any other payers

Total Part A Funds (Formula + Supp.) MAI Total Part B Funds (Formula + Supp. NJ) Total Part B Funds (Formula + Supp. PA) Total Part C EIS Funds (State & Local) Total Part D Funds (State & Local) Total Part F Funds
Last Year Allocation $6,600,170 $365,454 $812,384 $4,759,759 $2,481,614 $930,000
Current Allocation $6,606,720 $349,763 $3,762,013 $2,331,614 $620,000

Consumer survey info 2017 n=392

n Used in the last 12 months Needed but did not get (last 12 months)
Ambulatory Health Services 242 93.8% 6.2%

Community Survey 2022 Service Responses n=236

I never personally needed this service I needed this service and received it I needed but did not get this service I never heard of this service
Ambulatory Health Services 15.25% 53.81% 2.12% 2.12%

Unmet need

For the purposes of this document, need is based on the response of a consumer when asked if there was a service they needed. MMP interviews patients in care and asks consumers if they need a service and if they receive it. Client services unit data identifies needs at the time of initial intake.

2015-18 MMP Percent with a Need (weighted) 2021 Client Services Unit Need at Intake
Ambulatory Health Services 7.6% 22.8%

Recipient Service Considerations

Ambulatory Health Services

Part A funds 24 HIV medical care programs in the EMA. These outpatient/ambulatory care providers are located in hospitals, comprehensive services agencies, Federally Qualified Health Centers and in the City of Philadelphia Health Centers.

Service utilization declined slightly this year, with 165 (-1.5%) fewer clients accessing Part A/MAI HIV medical services. Meanwhile, the number of Part A/MAI medical visits decreased by 1,663 (-5.1%) in comparison to FY 2021. There was a 0.4% decrease in expenditures.

VL Suppression in the EMA increased from 85% to 86% during this period, likely due to more viral load tests being conducted as patients continued to return to in-person visits.