In chapter 5 we have reviewed major elements of ambulatory (outpatient) care and discussed changes supported by the Patient Protection and Affordable Care Act (ACA) and American Reinvestment and Recovery Act. Ambulatory care encompasses a diverse and growing sector of the healthcare delivery system. Ambulatory surgery is a continuously expanding component of ambulatory care, as new technology allows an increasing number of procedures to be performed safely and efficiently outside of the hospital. In addition to new diagnostic and treatment tools available in outpatient setting, financial mandates also have driven services into the ambulatory arena. This new development pushed more hospitals to shift procedures and services amenable to outpatient delivery from more expensive inpatient environment to less expensive. For profit, free standing facilities providing primary, specialty, and surgical services have been increased (Sultz & Young, 2014, p163-199).…