They're all making a similar bet: These disruptors can give patients better and easier access than existing channels. If health systems aren't careful, they risk losing core patient groups to these new entrants. In fact, over 60% of patients under age 45 already opt for a PCP-alternative (e.g., urgent care) as a first stop for common medical issues.
While providers don't have to replicate these disruptors' strategies, they do need to ensure easy access to care. To discuss innovative approaches to improve patient access, our team turned to medical group strategy expert Hamza Hasan.
Question: What are common missteps providers make when setting their patient access strategy?
Hamza Hasan: One big mistake organizations can make is automatically assuming they have an access problem. Leaders often lack data about what their actual existing practice capacity is and how much of it goes unused. This can cause leaders to perceive a patient access problem when the real issue is either unused or misused provider capacity preventing patient access. In this situation, leaders risk making significant investments in either recruiting new providers or in establishing new access points that they don't need.
Another common misstep is considering telehealth as a stand-alone access strategy. While telehealth can drive efficiency and expand reach, it is not yet fully viable due to limited reimbursement and patient preferences. Ensuring patient access is a complex effort to align provider time with patient demand for different services.
Q: How can providers expand access to appropriate care for patients?
Hasan: Primary care is no longer one-size-fits-all. Many disruptors are leveraging this trend by appealing to the access and convenience desires of a specific patient group. Organizations like ChenMed and One Medical have built their entire business models around serving a distinct population with easily identifiable needs (e.g., low-risk patients willing to pay for convenience).
Provider organizations that emulate this segmentation strategy often start with populations whose current utilization patterns contribute to significant pressure and costs in acute care settings. For example, Catholic Health System discovered that many of its Medicaid patients were unnecessarily using the ED because of transportation barriers, so it decided to construct a walk-in primary care clinic next door. ED-based nurse navigators will inform patients about the clinic in hopes of diverting future visits. Staffed by nurse practitioners, the clinic will provide walk-in care for immediate needs and connect patients to a PCP for ongoing care.
Q: Beyond increasing access to care, how are providers innovating to confront disruptors?
Hasan: As convenient care becomes the status quo, providers are getting creative to set themselves apart. In 2017, Northshore Medical Group launched a preventative genomic screening program across three large primary care sites.
Through the program, patients are encouraged to complete a family history questionnaire either before or during their PCP visit. Patients whose initial screen indicates potential risk for a genetically linked condition are referred for further genetic testing by their own physician or by one of several high-risk clinics. Depending on the type of testing indicated, the cost may be covered by insurance or paid out-of-pocket by patients. In the first six months of Northshore's program, an impressive 9,000 patients completed the online questionnaire. Of the subset that went on to have genetic screens, 15% turned out to have risks that called for additional clinical actions.