Demystifying Patient Access for Health Systems, Health Plans and Physician Groups
Learn about patient access and get relevant resources
What is patient access?
Patient access is the ability for healthcare consumers to receive the right care in the right setting at the right time.
Why is patient access important to health systems?
- Access to care directly impacts the quality of care. By improving patient access to healthcare, health systems are ensuring that patients receive care when they need it. Greater access helps strengthen patient compliance with treatment plans, a key first step toward improving patient outcomes. (Healthcare Finance)
- Expanded access helps providers retain patients and attract new ones. A multichannel, consumer-centric approach to patient access will increase patient satisfaction, leading to increased engagement and reduced leakage. Discover the key role a welcoming digital front door plays in protecting (and expanding) your network integrity.
→ Learn how four leading healthcare providers optimized patient access with digital solutions.
- Financial incentives are linked to a health system’s ability to attract and retain patients and effectively manage the health of its population. As value-based care gains traction, health systems will increasingly be paid based on their ability to manage entire populations. Improving patient access is an essential precursor to improving population health.
- Today’s healthcare consumers are proactive and increasingly expect to receive care when and where they need it. Patients will shop around if their current provider is not meeting their needs. According to a recent Accenture study, two-thirds of patients would switch providers if they could get an appointment they needed more quickly. Learn about five tactics to build patient loyalty, with a focus on enhancing digital patient access.
- Timely care is a factor in Consumer Assessment of Healthcare Providers and Systems (CAHPS) patient experience scores. CAHPS surveys ask patients to report on their experiences with health services, including whether they could get an appointment as soon as needed for urgent and non-urgent care.
Why is patient access important to health plans?
- Improved patient access is key to successful value-based care. Value-based care arrangements have created “payviders,” where payers and providers collaborate to reduce financial risk, increase profitability, and improve patient care. Learn more about payviders and trends in payer-provider collaboration.
- Increased network retention and use of appropriate level of care: Ready access keeps patients within the network, seeing appropriate care providers, and out of costly care settings such as the ED for non-emergent care.
- Improved patient engagement and potentially decreased costs: Patient access in the right setting, whether it be a retail clinic, physician’s office, or through telemedicine, can increase patient satisfaction, experience and compliance with care plans, reducing costs for that visit and, potentially, the patient’s overall care plan.
- Digital access points allow health plans to meet members where they are. More than half of healthcare consumers search for available providers and 43% look to schedule care through their health plan’s member portal or app. Improving digital patient access can build your brand and increase member engagement.
What are common barriers to patient access?
- Inconsistent access points that lack all of the information to readily schedule a patient with the correct provider at the correct time. Traditional access points can include call centers, health system websites, and care settings.
- Lack of a centralized scheduling system with full information on all providers within the system. This can result in long delays in care or even patients leaving the system to seek care elsewhere, when another provider at an alternate location within the system may have been able to provide clinically appropriate care.
- Lack of timely access to care or inadequate access to a provider. The average wait time for a physician appointment is 24 days – for a new patient, the average wait is 32 days. In addition, 16% and 10% of Medicaid and Medicare patients, respectively, report “never” or “sometimes” getting an appointment for urgent care as soon as needed. (CAHPS)
- Mismatch between existing patient access channels and the way in which savvy healthcare consumers increasingly seek out care. Traditional patient access channels such as call centers have fallen out of favor with Millennials, in addition to a growing portion of older tech-savvy consumers. Learn more about how different generations prefer to access care.
→ A recent study by Jefferson Health found that 71% of patients under age 40 expect providers to have online scheduling and offer them the ability to compare rates.
- No shows, appointments that patients skip without cancelling, create patient access issues and hurt health systems’ bottom line. They are estimated to cost the healthcare industry an estimated $150B in losses each year, cause patient flow problems, and can negatively affect the health of these patients.
- Restricted in-person access due to COVID 19 social distancing guidelines and deferred elective and preventive visits. A DocASAP survey found that 68% of patients cancelled or postponed an in-person medical appointment during the pandemic. Unfortunately, patients who cancel or delay care may face negative health consequences.
How can healthcare organizations improve access to care?
- Assess the current state of patient access and the patient access journey at your organization. Track key metrics such as time to first available appointment, number of cancellations, no-shows, reschedulings and appointment denials.
- Based on findings from your assessment, gather stakeholders to determine appropriate solutions and create implementation plans for these solutions. Several key solutions that have been shown to effectively improve patient access to healthcare follow.
- Offer weekend and evening hours. Consumers value convenience and the ability to get an appointment as quickly as possible. A recent DocASAP survey showed that 54% of patients would prefer to see their provider within seven days of scheduling their appointment. Online appointment scheduling provides patients the ability to book appointments 24/7. Consider extending provider availability to evenings and weekends to enhance access further.
- Expand access beyond traditional channels to leverage provider and health plan websites, provider profiles, third party listing sites, search engines, social media platforms, email/SMS outreach, and other mobile-friendly solutions. These digital solutions can help patients navigate to appropriate care, reduce administrative burden, avoid patient frustration due to unanswered calls, free call center staff and minimize costly no-shows. Discover nine tactics to optimize digital patient access.
- Leverage online navigation, matching and scheduling technology to meet patient needs and gain a competitive advantage. Enable patients to seamlessly schedule appointments according to their priorities and provide an easy-to-navigate provider directory to ensure that patients can easily find the right provider for them.
- Providing multichannel patient access tools, including online scheduling and telehealth services is a key part of reconnecting patients to care during the “new normal,” as the US healthcare system continues to battle the effects of the COVID-19 pandemic. Discover more strategies providers can take to enhance patient access, value and experience as they adapt to a new normal.
- Offer a choice of providers and care options wherever possible. Nearly half of those surveyed by DocASAP said they would see a different doctor in the same practice, and a recent study by Kaufman Hall said 70% of patients would consider virtual visits rather than travel to a physician’s office.
- Once you have implemented patient access solutions, measure and monitor results to enable continuous improvement. Metrics to track include:
- Improvement in patient access (time to appointment,, after hours bookings)
- Operational workflow improvements (reduction in call wait times, reduced contact center overhead, regulated call volume, reduced no-shows)
- Patient acquisition (number of new patients booked, provider website conversion rate)
- Patient satisfaction (patient reviews and surveys)
- Right level of provider and care setting for type of care needed