Kyruus Blog

Three Patient Access Models: How Health Systems Can Find The Right Fit

Screen Shot 2017-07-05 at 5.08.36 PM.png

Average new patient appointment wait times have increased by 30% across the US since 2014, and at the same time provider schedules often go underutilized.  Accounting for this apparent contradiction, known as the “patient access paradox,”  has led many health systems to explore different approaches to patient access with dual goals of increasing provider schedule density and improving the patient experience.

The right patient access model needs to address and resolve not only the above issues, but also a variety of additional pain points felt by the health system, provider, and patient. For example, health systems are concerned with network-level metrics, such as operational efficiency and patient retention; providers desire a sense of autonomy and control over their practice, but also want to tap into the broader patient demand of the network; and patients want a simple and consistent experience that overcomes the current gaps in care coordination they often face.

To solve these issues, health system executives must understand the benefits and challenges of each access model. Below is a brief description of the unique characteristics of the three primary access models along with some of the key points that health system leaders must consider when evaluating their approach to patient access.  

Distributed Access Model

  • Schedulers are physically dispersed among individual practices, scheduling patient appointments only for the providers in that specialty.
  • Staff members have specialized knowledge of the providers they support, their availability, unique scheduling rules, preferences, and other nuances in their individual schedules.

Pros: Relatively easy to implement, promotes direct communication between providers and schedulers, and allows existing patients to build a relationship with the practice rather than a call center.  

Cons: Health systems cannot distribute patient demand evenly across the provider network, often leading to longer appointment wait times. New patients experience difficulty and frustration identifying providers with the right expertise who can also meet important non-clinical factors, such as location, insurance, and appointment time.  

Co-located Access Model

  • A centralized access center where agents sit in pods (e.g., small groups for each specialty or large practice), meaning that they can only schedule for a single specialty.
  • Typically uses a single phone number which then redirects patients to the appropriate pod via a phone-tree.

Pros: Improved patient routing and operational efficiency thanks to the access center’s emphasis on standardization and call-related metrics, such as handle time and hold time.  

Cons: Requires significant planning and stakeholder engagement, yet does not fully capture all of the efficiencies possible with the integrated model. Agents lack the ability to decrease appointment wait times due to the limited visibility of provider schedules across the entire network.

Integrated Access Model

  • A centralized access center in which agents are cross-departmental, meaning they can schedule appointments for any specialty in the network.
  • Requires a single phone line so that all callers go through a central queue.

Pros: Optimizes network utilization because scheduling agents have full visibility into provider data and availability. Also streamlines the patient’s experience identifying an appropriate provider and scheduling appointments sooner.  

Cons: The central challenge is in designing an access center with the necessary technology and provider data to support the agent’s workflow and enable them to route patients across a range of different specialties and practices.  Significant change management efforts are also required.

When embarking upon a patient access initiative, the challenge for health system executives is in determining the access model that best fits their organization. To do this, leaders must first understand the unique benefits and challenges of each model and take into account the short-term and long-term impacts among each stakeholder group (the health system, provider, and patient).   

Want to learn more about determining the the right patient access model for your organization?  Download our free white paper, Healthcare Patient Access Models - Understanding the Implications for Patients, Providers, and Health Systems, today!

Topics: Patient Experience Patient Access Access Center Provider Networks