Practice Notes

Reality check: 4 myths about your patient access strategy

by Ayal Bitton and Duane Reynolds

Expanding access in the medical group is just plain hard to do, and we know it's a top-of-mind issue for health care leaders.

On a daily basis, we speak with medical group executives and practice administrators who are working long hours—on top of their regular jobs—to ensure their sites meet patient and network demands for access. Across these conversations, we've found some common misconceptions about what makes a successful access strategy. So let's set the record straight and debunk a few access myths.

Myth #1: Increasing access is all about making providers more productive

Reality: This oversimplification of the real challenge to patient access is a leading culprit for why many efforts fail. We recently worked with a medical group that was solely focused on driving productivity through merely adding visit slots and double booking. While this may have added more patients in the short-term, the group quickly saw backlash from overworked providers—not to mention unmanageable waiting rooms with frustrated patients.

Yes, productivity is an important indicator of whether a provider is operating at an appropriate level of efficiency. But as a true competency, patient access is a much more complex effort to align provider time (our "inventory" in health care) with patient demand for different services—and resolve inevitable discrepancies and lags in balancing that equation. It's a strategic error to focus on how much capacity we can squeeze out of providers, and we will only perpetuate capacity problems if other issues are not addressed.

Myth #2: Practice managers are primarily responsible for access performance

Reality: On any given day, practice managers are busy making sure the shelves get restocked, staff call-outs are covered, chart documentation is complete, charge edits are done, budgets are tracked, outcomes are reported, and new providers are credentialed (not to mention that broken desk chair at registration that needs to be replaced).

Administrators are occupied with ensuring a practice runs smoothly; but more importantly, they are not always best positioned to lead patient access efforts—a function that requires a certain set of tools, analytics, and skillsets to diagnose the root clinical or operational barriers to success. For example, it's unreasonable to expect many practice managers to sit down and analyze the root causes behind patient no-shows while continuing to operate at a high level across all other responsibilities.

Myth #3: Investing in an access function means "centralization" away from the practice

Reality: Just because practice managers can't solve patient access on their own doesn't mean this myth is true. Many of our access conversations begin with the idea that investing in access means centralizing phone management and scheduling (much to the chagrin of practices and providers). That's not to say that centralized contact centers aren't or can't be important assets. When implemented effectively they can be powerful differentiators, and every organization should carefully consider what functions they are prepared to organize at scale.

But our take is a little different. Strategically investing in access is not always rooted in centralization, or contact centers for that matter. And as a core organizational competency, patient access is certainly not about taking control away from practices and providers. Rather, it means marshaling the resources to support practices with important capabilities they don't already have, such as capacity analytics or referral management resources, to name a few. And most importantly, it's about strengthening and deploying critical capabilities (new or existing) to help each site adopt efficient scheduling, understand market demands, and mitigate challenges to patients receiving the care they need.

Myth #4: Access reporting is enough to drive meaningful change 

Reality: While an analytics function may be a good first step to diagnosing barriers to access, it is unreasonable for leadership to rely on data alone as a meaningful change lever—or to expect that practices will feel inspired (or know how) to re-engineer clinical and operational processes in response.

The key ingredient for driving meaningful change to access performance is physician leadership; this is among the most important lessons we share from our experience. Physician leaders, formal and informal, offer critical input to shape and standardize important facets of access for their respective specialties. They also champion these efforts among peers and colleagues—the best antidote to provider resistance which can be initiative-halting.

Recently, our team helped a client in the East create an access council led by several influential physicians (only some of whom, by the way, had any formal titles). This council was essential to developing a standard set of access guidelines and principles that dramatically changed the way the system now defines and administers its access strategy. With the subsequent engagement and participation of other providers, the organization has since realized improvements in no-show rates, third next available appointments, and contact center performance—not merely because of the standards themselves, but because providers have embraced that they're worth having.



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