5 reasons to address access to care
This video highlights the top five reasons for a healthcare organization to address access to care for their healthcare members:
- Increased weighting of access to care and CAHPS for Medicare Advantage (MA)
- Tying to HEDIS measures and downstream impact
- New members in the new year
- Longer-term members engaged ahead of measurement season
- Value-based care impact particularly for duals, Medicaid, and social determinants of health (SDOH)
Video Transcript
The reason our clients focus on this as a measure is they're looking to improve experience CAHPS and Stars. I think everyone is very aware of the increased weighting of the CAHPS and the access to care measures for the Medicare Advantage population, the importance of getting those members into their providers and to get it in a timely fashion, whether that's routine care or urgent care. Obviously, multiple questions point towards those access measures.
The other is understanding how access to care really is the gateway.
So, if you think about this from a member experience perspective, the same way you think of onboarding members through your sales channels, this is really the first step in terms of getting those members into the care environment. And if you're going to have an impact on those TDIS measures, on care gap closures, you need to make sure that those members that haven't seen their providers are getting in to see the providers or those who haven't had the care gaps closed are, again, being seen in a timely fashion, especially ahead of capacity.
We're out of open enrollment, so we have a few new members who may have joined our plan. So navigating your plan, whether it's open from more of a PTO perspective or in kind of a closed network, ensuring your members understand how they can best access care, whether they're a legacy primary care physician, hopefully, they're a part of the network and they're available to be that legacy provider, or if they need to connect with a new primary care provider or specialist, how are you going to make those connections?