The Patient Will See You Now: Rethinking Access in a Consumer-Driven Care Model

The challenge of helping patients get the care they need when they need it has plagued healthcare providers for generations. But the dynamics of patient access today are in some respects unique. Health reform is leading more and more patients to obtain health insurance coverage, but that’s only part of the picture. A variety of factors, ranging from high-deductible health plans to the availability consumer-centric health technologies, are prompting many patients to take a more active role in managing their care. At the same time, nontraditional care settings are expanding in number and popularity. Retail clinics, urgent care centers, and pay-to-play video consults hold a growing appeal for patients seeking convenient care.

The traditional approach to access in the healthcare system has been to simply allow patients to wait in line – something that patients are increasingly unwilling to do. Organizations that adopt innovative strategies to expand patient access across multiple points of entry stand to enhance the patient experience, keep patients within the system or network, and remain competitive in a crowded market.

A successful patient access strategy requires an understanding of patients’ needs and an assessment of an organization’s capacity to meet them. Approaches will differ depending on providers’ readiness for change, but below are several strategies that organizations have been employing to improve access.

Telehealth – Providers have historically been lukewarm to the idea of delivering care via technological and virtual platforms. Many have had concerns about the logistics and efficacy of care rendered in a non-office-based encounter, and payors have typically imposed restrictions on reimbursing for telemedicine services. But advances in technology have vastly improved the virtual physician/patient experience; new state and federal legislation is removing barriers to telehealth reimbursement; and patient demands are pushing providers to consider ways to safely dispense medical care though these means.

Enhanced Online Care Tools – The patient portal is not a new technology, but health systems are still learning to maximize its use. Portals can enable secure email exchange between providers and patients, online appointment scheduling, and real-time access to medical records – all features that patients commonly request. Additionally, other online provider/patient matching tools have made it easier for patients to schedule appointments and find the right provider to care for their specific condition.

Patient Contact and Referral Centers – Long considered to represent the opposite of patient-centered care, contact centers have become a tool for getting patients connected to the right provider. A modern patient contact center can be an extension of the physician practice environment, providing 24-hour call access and preventing leakage from the system/network.

Open-Access Scheduling and Expanded Care Settings – Open-access scheduling aims to improve the patient experience by eliminating backlogs and allowing for more same-day appointments. It may involve limiting restrictions on appointment types and eliminating most future scheduling of appointments. Many organizations are also expanding evening and weekend hours to compete with “convenient care” clinics.

As patients take on a bigger role in managing their care, they’re becoming more informed, more savvy, and less willing to wait. They’re demanding quick, easy access to care at a reasonable price, and they have an increasing number of nontraditional care options to choose from. So providers that aren’t willing to think beyond the traditional model of care may indeed see their lines getting shorter – but not for the reasons they want.

This entry was posted in Care Model, Operations, Operations Improvement, Patient Access and tagged , by Jennifer Gingrass. Bookmark the permalink.

About Jennifer Gingrass

For more than 10 years, Jennifer has focused on physician practice issues, ambulatory operations, process redesign, and medical group/hospital integration. Her practice concentrates on the organizational, strategic, operational, and financial alignment between large multispecialty group practices and affiliated health systems to achieve care delivery integration. She has served as an interim executive at a 2,000-physician management services organization, leading large-scale operational/information technology changes across employed physician groups. More recently, as industry incentives have shifted to value-based care delivery, Jennifer has led accountable care strategy engagements, with a focus on the reimbursement impact, required operational change, and necessary cultural transformation. She is a frequent speaker at American Medical Group Association (AMGA) and Healthcare Financial Management Association (HFMA) industry meetings. Prior to joining ECG in 2004, Jennifer worked in health/welfare benefits consulting at a global consulting firm. Previously, she provided day-to-day physician practice management. Jennifer holds a master of science degree in health systems management from Rush University and a bachelor of science degree, with an emphasis on science-business, from the University of Notre Dame.

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