Physician Supply. On a strategic level, there may simply not be an
adequate supply of physicians to meet the access needs of the country even if these internal and external barriers are addressed. A study
commissioned by the American Association of Medical Colleges in 2017
revealed that the United States will face a shortage of between 40,800
and 104,900 physicians by 2030; the numbers of new primary care
physicians and other medical specialists are not keeping pace with the
demands of a growing and aging population. 7 If traditional delivery systems and reimbursement models that favor patient-facing visits persist,
the velocity to treatment will continue to lag. Innovative delivery and
reimbursement models that extend provider reach and permit provider
collaboration are required.
Healthcare leaders must create strategies to
proactively address barriers that prevent inroads
to patient access. This internal work, combined
with engaging insurance payers to determine
alternatives to current reimbursement policies,
must be at the heart of the nation’s healthcare
dialogue. Without taking a thorough “history and
physical,” we cannot create an effective plan of
care for our nation’s diagnosis of poor, costly,
and ineffective access.
Elizabeth W. Woodcock, M.B.A., FACMPE, CPC,
is founder and executive director, Patient Access
Slow but Sure Progress
The Patient Access Symposium®, a collaboration of 61 academic
health systems, reports that 63% of members have integrated
automated provider matching solutions through their man-
agement information system or a bolt-on third party, with the
remaining organizations having protocols on dynamic files. These
strategies are slowly but surely facilitating scheduling within an
organization, such as permitting a primary care office to directly
schedule a specialty care visit. Outside of large, sophisticated
health systems, however, the current state reveals that manual
systems continue to punctuate today’s scheduling processes.
1. Rates cited are 2018 national Medicare rates. For 99214, the rate
reflects the non-facility reimbursement schedule. The American
Medical Association publishes the CPT©.
2. N. Caldwell, T. Srebotnjak, T. Wang, and R. Hsia. 2013. How Much
Will I Get Charged for This? Patient Charges for Top Ten Diagnoses
in the Emergency Department. PLoS ONE 8( 2): e55491. Accessed
May 16 at doi.org/10.1371/journal.pone.0055491.
3. Agency for Healthcare Research and Quality. 2013. Medical Panel
Expenditure Survey, January 23, 2013. Accessed May 16 at meps.
4. National Center for Health Statistics. 2017. Health, United States,
2016: With Chartbook on Long-term Trends in Health. Table 76.
Visits to physician offices, hospital outpatient departments, and
hospital emergency departments, by age, sex, and race: United
States, selected years 2000–2013. 286–288. Accessed May 16 at
5. Blue Cross Blue Shield of North Carolina. 2012.
Non-Emergency Emergency: Reducing Avoidable ER Visits. Blue
Cross Blue Shield of North Carolina, Provider News (undated).
Accessed May 16 at bluecrossnc.com/provider-news/
6. L. Uscher-Pines, J. Pines, A. Kellermann, et al. 2013. Deciding to
Visit the Emergency Department for Non-Urgent Conditions: A
Systematic Review of the Literature. American Journal of Managed
Care, 19( 1): 47–59. Accessed May 16 at ncbi.nlm.nih.gov/pmc/
7. S. Mann. 2017. Research Shows Shortage of More than 100,000
Doctors by 2030. AAMCNEWS, March 14, 2017. Accessed
May 16 at news.aamc.org/medical-education/article/