Charting the Path to a Consumer-Centric Care Access Model

By Annie Zilius, Danielle Roth, Jayme Letarte, Austin Meier

Demand for more seamless care and industrywide pressure to grow while simultaneously reducing costs are incentivizing healthcare organizations to re-imagine care access to meet consumers’ evolving needs.

In Huron’s survey of healthcare executives, leaders list care access transformation as a top trend impacting their organizations in the next three to five years. Other trends on executives’ radar, including health system capacity, revenue growth, ambulatory care expansion, and virtual care, all depend on an organization’s ability to provide a seamless access experience, increasing the urgency for improvement.

Traditional levers, such as increasing physician availability and modifying scheduling templates, won’t be enough to transform care access. Point solutions and access strategies that vary between care settings need to be replaced with a holistic approach.

Change starts with building alignment across the organization. From there, organizations can design technology- and data-enabled care access models that allow for strategic growth and the ability to provide consumers with the care and resources they need at every step along their healthcare journey.

As health systems look to improve access, leaders need to start by ensuring their organization has a clear vision that aligns with the needs of their consumer populations and organizational goals. Two fundamental questions can guide assessment:

• Is our operating model structured to support the care access experience we want to deliver?
• Do the organization’s service offerings and care model align with our community’s needs?

Aligning Internal Structures and Leadership to Support Outcomes

With the growing number of care settings, locations, and services that healthcare systems offer today, and the resulting matrixed governance and operational complexity, aligning leaders and functions is imperative to improving patient access.

To operate as a cohesive system, leaders must agree on the overall access experience and outcomes they want to drive, which should tie back to the unique needs and preferences of an organization’s consumer base. Engaging the broader leadership team in defining the vision and outcomes builds the accountability and buy-in needed to jump-start and sustain a new access model and ensures future decisions support the end goal.

Healthcare leaders should be evaluating how their current operating model may be impeding progress and hindering patients from having a seamless access experience. Functions traditionally managed separately, such as scheduling, clinical intake, revenue cycle, patient experience, and marketing, should be anchored by the system’s unified consumer-centric strategy rather than siloed departments with function-level objectives. This alignment requires leaders to shift from an inside-out mindset to an outside-in approach where consumers’ needs guide both structure and strategy.

Understanding Community and Individual Needs to Meet Demand

While internal alignment provides the structure and consistency needed to improve care access, organizations also need to ensure their service offerings match the needs of their community and reflect how consumers want to receive care.

Market demand should drive an organization’s clinical and geographic footprint and future growth. If a health system’s resources and services are not aligned with consumers’ health and well-being needs and goals, access issues will persist.

Shifting to a consumerism mindset requires not only knowing a population by demographic or disease-specific segmentation but also understanding consumers’ attitudes, values, and preferences toward how they use healthcare. Data and technology provide the visibility healthcare leaders need to better understand and serve the consumers in their market. Advanced data and analytics take that data to the next level to predict how demand will shift based on consumers’ future needs.

Once the foundational components are in place to support a consumer-centric access model, organizations can more nimbly implement innovative solutions to elevate the future of care access. To stay ahead, healthcare organizations should be thinking about:

Digitalization to create timely, seamless consumer interactions: Building an omnichannel access experience is essential in a growing digital landscape and as organizations continue to expand outside their zip code. To meet consumers where they are, organizations will need to manage communication across all channels, including patient portals, text, chat, web, and phone. Investments in automated and self-service technologies will be imperative as consumers continue to demand more functionality and convenience.

Contact centers as more than a scheduling function: Huron’s survey of healthcare consumers finds that 67% of individuals prefer a single point of contact for their healthcare needs. In response, forward-thinking leaders are reenvisioning contact centers as engagement hubs, taking the function from a cost center to a demand- and revenue-generating solution inclusive of scheduling, clinical intake, care coordination, social needs screenings, consumer outreach, and other components that impact care access.

To enable this transformation, organizations must figure out how to seamlessly integrate core and emerging technology to give staff a 360-degree view of consumers and their care journeys. For example, customer relationship management (CRM) platforms, when intentionally deployed to support operational workflows, can provide visibility into patients’ touch points with the organization to drive more informed and valuable consumer interactions.

Advancing health equity and social determinants of health (SDOH) initiatives: Building a system that works for everyone will require not only understanding the needs and challenges of an organization’s patient populations but having trained staff and resources to connect patients to relevant services. Next-generation care access models will be built with a broad range of consumers in mind and use data to support the health and well-being of individuals and communities while alleviating disparities that keep people from achieving the best possible health outcomes.

Improving care access is a continuous journey. Creating a flexible access model anchored by the consumer enables organizations to better respond as the market shifts and consumer needs and preferences evolve. Organizations that can build alignment across their systems to seamlessly engage consumers from end to end and meet demand with appropriate resources and services will have the ability to not only improve care access but create a foundation for broader care transformation.