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5 critical components of patient access

Insight Article - July 17, 2018

Operations Management

Patient Access

MGMA Staff Members
Some medical practices don’t see the need to shorten patient wait times for appointments. As one provider put it: “Just because patients think their clinical issues are urgent doesn’t mean they can’t wait until tomorrow.”

It’s true that for some patients, waiting a day or two to be seen will make no difference in terms of the quality of care or the outcome. However, the benefits of improved access go beyond patient accommodation.
 
Consider this scenario, as adapted from Patient Access: Tools and Strategies for the Medical Practice, by Elizabeth Woodcock, MBA, FACMPE, CPC and Deborah Walker Keegan, PhD, FACMPE:
 
Karen is an established patient of a primary care physician based in a multispecialty practice that is recognized as a patient-centered medical home. Upon experiencing abdominal pain, Karen called her primary care physician’s office to request an appointment. She was informed that her physician didn’t have an open slot to see her that day. Karen asked to see another physician or an advanced practice provider in the practice instead, only to be told that no same-day appointments for her condition were available from any of these providers.
 
Her next recourse was a retail pharmacy clinic, where she was turned away because the staff said abdominal pain was too complicated a matter for them to handle. She then went to an urgent care facility, where the physician ordered an ultrasound and an x-ray, but no definitive diagnosis was provided. On her way home, Karen’s abdominal pain worsened and she presented to the emergency room for a full workup.
 
This example illustrates how long wait times and rigid scheduling rules can impede optimal patient access — and consequently, business opportunities. If Karen had been granted a same-day office visit, both she and the medical practice would have benefited. Karen would have been seen in a timely fashion, with streamlined access to care involving internal referrals to imaging and to a specialist within the same multispecialty practice as her primary care physician.
 
The practice would have received the significant revenue associated with a primary care office visit, imaging, and the specialist visit and subsequent procedures. What’s more, Karen’s frustrating experience will likely motivate her to find a new primary care physician, and her friends and family will be warned to stay away from this practice.
 
To avoid this fate, consider building a strategy based on the following five critical components of patient access.
 
  1. A balance of provider supply and patient demand: Evaluate current capacity to meet demand and work to expand capacity if necessary.
  2. Scheduling optimization that allows patients to easily obtain appointments: Modify current scheduling methods to remove barriers and ensure patients can been seen as soon as possible.
  3. A telephone management strategy that makes efficient use of staff time without sacrificing the quality of service: Analyze data points such as inbound call volume, time to answer, reasons for calls and average call duration to pinpoint areas where improvement is needed.
  4. Digital communication and telehealth options that give patients additional ways to interact: Patients need access to care 24 hours a day, seven days a week — and expect providers to utilize technology to meet this need.
  5. Key performance indicators to provide ongoing measurement and monitoring to assess performance: Factors such as lag time, conversion rate, scheduled but not arrived rate and patient feedback can help you assess your current state of patient access and track improvement.

Want to learn more?

"Access Optimization 101: 10 Steps for Meeting Patient Needs" is just one of the dozens of engaging sessions you can attend at MGMA 18 | The Annual Conference, Sept. 30-Oct. 3 in Boston.
Get the details and register.
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