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February 28, 2017

The 5 lessons Allegheny Health Network learned from offering same-day specialist appointments

Daily Briefing

Pittsburgh-based Allegheny Health Network (AHN) in January launched same-day appointments for almost all specialists. In Managed Healthcare Executive, Karen Appold rounded up five takeaways from AHN's experience.

According to Appold, the same-day access to specialists comes about a year after the system implemented same-day appointments for primary care physicians. AHN overhauled its call center and revamped its clinical scheduling system to make such same-day services possible.

1. Working with different specialists requires different approaches

Citing the months-long implementation process, Kenyokee Crowell, SVP for Clinical Access at AHN, said, "We worked closely with physicians and office managers at different sites to try and predict what patient needs would be for each specialty." She added, "You can't take a cookie cutter approach to all specialties; there isn't a perfect recipe."

Ultimately, AHN officials realized the "key" to getting the scheduling to work was setting inventory ahead of time, Appold writes. Crowell noted that most physicians' schedules are totally full, meaning the only way to make same-day appointments work was to make room ahead of time.

Another approach is to fill spots that open up because of cancellations, Appold reports.

2. A single hub handles appointment requests

The system funnels all same-day appointment requests through a central hub: To schedule their same-day appointment with AHN, patients call the Care Connect Access Center between 7 a.m. and 11 a.m. on weekdays.

AHN then finds the most appropriate provider based on the patient's need and the service availability. The appointments are offered on a first-come, first-serve basis. If a patient calls after 11 a.m., he or she can choose between making a same-day appointment, pending availability, or signing up for the next available appointment, Crowell said.

3. High reward

Allowing patients to schedule same-day appointments could lead to a better patient experience and lower costs, Appold reports. Plus, according to Crowell, same-day access to specialists can allow patients to have their situation handled in an office rather than an ED.

Elie Aoun, medical director for Clinical Access, said, "Expediting access to health care services positively impacts the entire patient experience." Aoun added, "By eliminating long wait times for appointments and addressing a patient's health concerns in a more timely and well-coordinated fashion, better clinical outcomes can be achieved."

4. Be aware of prior authorization requirements

Insurance authorization requirements can impede some patients' ability to schedule same-day specialist appointments, and so AHN "always encourage[s] patients to be familiar with their health insurance coverage and any limitations," Crowell said.  

The system has had to be flexible with those requirements as well, Crowell added. For instance, she pointed out that AHN does not offer same-day procedures or ancillary testing, as they often need pre-authorization.

5. A move toward patient-centered care

Crowell considers same-day appointments a cornerstone in developing a patient-centered access model. "Many industries have on-demand access to meet people's needs," she said. "Health care is lagging behind a bit. Nationwide, norms for wait times to see a specialist can be three weeks or longer."

According to Crowell, patient satisfaction with same-day primary care appointments is at 96 percent. AHN intends to do a similar study of same-day specialty care appointments (Appold, Managed Healthcare Executive, 2/16). 

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