Care Access Transformation in the Modern Era

By Mark Benninghoff, Karen Zhao, and Gabriel Knight

Executive Summary

Care access and scheduling often represent key pain points for hospitals, health systems, and other providers, and must remain key areas of focus in assessments and initiatives in order to achieve a high-performing physician enterprise. New means and models of care delivery, as well as rapid technological advancement, have precipitated significant ambulatory care access transformation. To demonstrate value and facilitate meaningful change, decision-makers must adapt to these changes, while still incorporating tried-and-true techniques.

What is Care Access?

Care access represents everything that affects a patient’s ability to access the right care at the right time, in the right place and with the right provider. Providers can engage patients in several different ways, including:

  • Acute care, including emergency department (ED) and urgent care visits
  • Chronic care, including recurring face-to-face scheduled appointments
  • Annual physical/wellness visits
  • Home visits
  • Nursing home visits
  • Post-discharge visits from hospital
  • Hospital visits/critical care

Furthermore, in this digital era, providers are connecting with their patients using several remote or digital methods. The choice to discuss care access, as opposed to patient access, extends beyond semantics; care access broadens the discussion of care delivery to include nontraditional modes of healthcare, such as video-chat consultations or patient phone calls facilitated by care coordinators. Thus, not only do patients routinely present with different illnesses and backgrounds, but each patient can receive care or counsel from their provider or clinic in many ways.

Historical Context and Problem Definition

Understanding the many complexities and nuances surrounding access is crucial. After all, scheduling and access are the first lines of defense against patient dissatisfaction and inefficiency. Given the innumerable downstream effects of each method and model for scheduling patient care, it is crucial that providers and decision-makers focus special attention on this bottleneck.

Optimizing patient scheduling to ensure maximum patient access to care — while minimizing overall cost — is a difficult endeavor. As discussed above, many factors and advancements have complicated this problem.

Different models for scheduling and access have been tried and tested over the years. In traditional models, providers’ schedules are booked months in advance, leaving little flexibility in schedules despite new demand daily. Unsurprisingly, this has historically led to inefficiencies as well as patient dissatisfaction, especially with those who are imminently ill and require more urgent care.

Several other factors have driven this need for change in the way we approach patient access and scheduling — most notably, the profound shift toward value-based payment models. With increased emphasis on quality outcomes versus simple volume and output, coupled with ever-important patient satisfaction metrics, patient scheduling can no longer be driven solely by efforts to increase the number of patients coming in and going out of the clinic.

Scheduling and access have also been complicated by the growing number of ways patients can visit their doctors, especially with rapid technological advancement. The advent of telehealth methods, for instance, has paved the way for alternative doctor visits and consultations, challenging existing conceptions and protocols. Finally, the increasing diversity in provider types and support staff, each with different skill sets and billing rates, necessitates looking at each prospective patient in a more nuanced way.

Read Full article

About the Experts

Back to top