Healthcare Access: Why It Doesn’t Stop at Your Door
By Jason Messerli, Strategic Advisor, Customer Strategy, NRC Health
Access is something that I always took for granted.
I was very fortunate. My mom has been a nurse for over 50 years, and while I was growing up, she knew every primary-care physician, every specialist, and seemingly every nurse.
As an accident-prone child, I never worried about getting an appointment or finding the right specialist. She always knew whom to call, what next steps to take, and why.
But what about the folks who don’t have the luxury of a seasoned healthcare professional in their own home?
Healthcare organizations have devoted extensive resources to improving access, with notable success. More appointment availability, flexible/extended office hours, alternatives to in-person visits, and new types of services have all played a part in shaping a more accessible healthcare landscape.
True access means helping people navigate an increasingly complex healthcare system with confidence. It means removing uncertainty, reducing friction, and making it easier for patients to get the care they need—not just once they arrive, but at every step of the journey.
How are you uncovering and improving friction points today? Are you listening to patients at every point of the care journey?
After all, you can’t let someone in your front door if there is no one there to answer.
What Does Healthcare Access Really Mean?
In NRC Health’s latest quarterly nSight, we examine access in greater detail. We walk through where progress has been made, where there is still opportunity, and how expectations of access differ by generation.
One of the most helpful ways to think about access is through the construct of time. A patient’s time arises as the most important factor in how they experience and evaluate access.
We can’t create more time, so it’s something most people guard closely. From this finite commodity, we see two elements emerge that are critical to access.
The first element is “time saved.”
Why Is Time Saved Only Part of the Equation?
Time saved tends to be where most organizations focus their attention, from an access standpoint. How quickly can we get patients in the door?
But when it comes to navigating healthcare, simply getting an appointment quickly isn’t enough. Differing patient expectations and preconceived notions of what their care should look like impact a patient’s perception of access. Are you leveraging your qualitative data in a manner that uncovers where these expectations are met, and where they’re not?
I once worked with a partner who noticed a growing number of negative comments about wait time. This was seen as an access issue at face value, but our AI-integrated qualitative tools largely revealed a different story: patients had extensively reported waiting for, but never receiving, a call back from the organization.
This sparked further investigation by our partner. What they found was that there were a large number of active voicemails that were not being monitored.
This highlights the critical importance of using both qualitative and quantitative data to inform your access endeavors.
Time saved tends to be the reason why younger generations routinely and purposefully fragment their care. It’s also why, personally, I often choose Urgent Care when I’m sick; it saves me time.
The good news is that healthcare has made substantial progress over the past decade. Appointment availability, scheduling ease, and wait times have improved across all care settings.
However, there’s still room for growth. While older generations report experiencing no access challenges 59% of the time, younger generations report greater difficulty accessing nearly every type of care.
The bar for “timely” is also rising. For routine, specialty, and chronic care, younger demographics are more likely to expect care within one week.
In short, great work is being done, but there are still aspects of “time saved” that organizations may not be able to control.
This is where the concept of “time well spent” comes into play.
What Happens When Time Is Well Spent?
The act of getting someone an appointment does nothing if the rest of the patient’s experience falls short. If they leave feeling unheard, devalued, or not listened to, they will likely feel worse than they did before the experience.
If time together is spent well, clinicians simplify things, transmit confidence, and help the patient leave with a good understanding of next steps.
When time is both saved and well spent, it helps to reduce the friction that patients experience in accessing and utilizing healthcare.
How Does Friction Impact Loyalty?
Looking across the care continuum before, during, and after a care experience, we discovered a 40-point difference in likelihood to recommend from those organizations that reported “no friction,” versus those that reported friction at all three stages of care.
It is this repeated breakdown that becomes increasingly difficult for patients to look past.
This highlights how imperative it is to gather feedback across the entire care experience to identify friction points and barriers to care. If we don’t ask, we may never know.
Why Is Access Ultimately About People?
Years ago, I conducted an exercise with caregivers. I asked everyone to close their eyes and think briefly about the most difficult moments in their lives. Then, I asked that they think of the main person who was there for them during that time.
Many shared that they remembered the person well—what they looked like, how they helped, and even what they said.
Then I asked them to open their eyes, and I told them that I envied them, because they have the opportunity to be that person for someone, each and every day they come to work.
Some of those providers’ patients are going through the worst time of their lives, and they can help assuage their worries, answer questions, and offer support.
So access isn’t just about accessing a service.
It’s accessing a human being who knows much more about something than you do.
It’s accessing someone who can help calm your mind and give you a path forward.
It’s accessing hope.
