Consumer access improvements drive leading health system's transformation

Challenge

A large Northeast health system found itself at a crossroads. Amid post-acquisition expansion, the system faced significant access challenges that jeopardized patient care, operational efficiency, and market competitiveness, including:

• Underutilization of resources: Providers, staff, equipment, and facilities were not being deployed effectively, leaving critical capacities idle.
• Fragmented patient navigation: Patients struggled to access care within a large network of campuses and clinics, exacerbating delays in treatment.
• Call center inefficiency: An outdated, overwhelmed call center faced an eight-day backlog for referrals and order inventory for diagnostic and ancillary services. Inefficiencies led to a 5.6% call abandonment rate, compounding patient dissatisfaction and decreased volume.
• Market share erosion: Neighboring health systems and standalone centers began absorbing patients, threatening the health system's position as a trusted provider.
  
  

In the face of growing competition and internal inefficiencies, the health system required a transformative solution to restore its leadership in patient care and operational excellence.

Approach

Recognizing the urgent need for a systematic overhaul, health system leaders leveraged an existing partnership with Guidehouse to engineer a forward-thinking access strategy—one that refined how patients engage with care while unlocking organizational potential.

Our approach centered on creating a single access center capable of managing patient traffic with unmatched precision and efficiency. By capitalizing on advanced technologies and reimagined workflows, the health system was able to streamline scheduling, financial clearance, and resource utilization. This move sought to make access not just a function but a strategic advantage.

Key initiatives included:

Automation and process optimization: With our guidance, the health system identified and eliminated outdated order and referral inventory and developed an infrastructure to minimize future inflow, allowing them to focus solely on actionable workflows.

• Automation tools enabled staff to prioritize schedulable cases, significantly reducing delays and errors.
• A robust omnichannel communication strategy integrated call, text, and digital messaging, creating seamless engagement with patients while driving inbound and outbound efficiencies through targeted marketing campaigns.

Dynamic key performance indicator (KPI) reporting: Leaders worked with our team to develop an executive dashboard that delivered unprecedented visibility into operational metrics.

• Over 30 performance indicators, including scheduling and financial clearance metrics, allowed leaders to benchmark results against world-class standards.
• Indicators far exceeded what the health system had access to previously, permitting drill-down capabilities that helped leaders more seamlessly track opportunity areas and showcase improvement post-implementation.
• Real-time insights uncovered bottlenecks, enabling proactive decision-making and showcasing the transformative impact of centralized access.
  

Scalable centralization: We helped develop a centralization roadmap was developed to unify scheduling and financial clearance processes across the enterprise.

• Centralization sprint cycles were organized to align with the system’s medical and surgical institutes, achieving implementation in 12-week cycles.
• Electronic health record and telephony systems were modified to support workflow integration, enabling each service line to leverage the KPI monitoring and gain greater transparency into performance.
• The centralization model incorporated a continuous review process to make staff allocation real-time decisions that match consumer demand, and improved performance metrics enabled greater efficiencies.

Impact

Centralized scheduling and financial clearance functions transformed operational capabilities and the patient experience, enabling the health system to:

• Achieve industry standard for scheduling: Scheduling inventory backlog decreased from 8.12 days to 1.63 days.
• Increase appointment volume: Appointment volume increased by 16.1%.
• Improve scheduling efficiency: Call abandonment rates decreased from 7% pre-centralization to 3% after implementation, referral lag days were down by up to 75%, and leaders reported a 15% reduction in surgery call abandonment.
• Enhance the patient experience: 85% of calls are now answered within 15 seconds, up from 68% previously, minimizing hold times and ensuring timely care.
• Boost retention: Order-to-appointment conversion rates increased by 10%, enhancing patient retention rate and satisfaction.

This health system's transformation was not merely operational—it was cultural as well. By embedding access as a strategic priority, leaders turned inefficiencies into opportunities for excellence. This engagement demonstrated how data-driven insights, technology, and collaboration can reimagine patient care delivery. With this bold approach to strategic access, the health system has positioned itself for long-term success.