Access will define healthcare’s next era
Article | April 28, 2026
Reading time: 6 mins
Access in healthcare is still framed as an operational problem—appointment availability, clinic capacity, call center performance—but despite sustained investment in each, access remains one of the most persistent points of friction for patients and providers.
That’s because the issue is not simply capacity. It’s how effectively systems connect patients to that capacity.
In most industries, access is not experienced as a challenge. It’s assumed.
Consider GPS. Modern navigation tools do more than display available routes. They guide individuals along the most efficient route based on real-time conditions, destination, and need. The system absorbs complexity—anticipating, directing, and adapting—so people reach their destination with minimal friction.
Healthcare, by contrast, still requires the patients to navigate its systems themselves.
That gap reflects a deeper issue: the absence of a unified definition of access that spans the full care journey, not just the point of entry.
Access is a system responsibility—but it’s tested in ambulatory care
For years, organizations treated access as a function of supply and demand, offering more providers, clinics, and appointment slots. While these efforts matter, they’re not enough.
Access is not simply the presence of capacity. It’s the system’s ability to connect individuals to appropriate care—at the right time, in the right place, with the right team—without unnecessary friction or inequity.
At its core, access is a measure of systemness.
The limitations of current access models are most visible in ambulatory care where demand first emerges, care pathways begin, and patients are directed across primary care, specialty services, and procedural settings. It’s also where access most often breaks down—through specialty referral delays, inconsistent scheduling practices, and disconnected entry points.
Even among organizations actively working to improve access, foundational gaps persist. According to a Vizient Member Networks Performance Improvement Programs benchmarking study, only 27% of respondents have a formal process to track and monitor access barriers. While nearly all operate clinics at least five days a week, fewer than one-third offer care outside standard business hours.
Many ambulatory models remain locally optimized rather than intentionally designed. Capacity exists, but it’s not coordinated or easily navigable. Patients can enter the system, but their movement through it is often fragmented.
At the same time, demand is becoming more complex and sustained. A Vizient Research Institute study shows that 80% of inpatient admissions involve patients with at least one chronic condition, and the 75+ population is projected to grow 44% over the next decade.
To manage care effectively and efficiently, a defined ambulatory governance structure is essential. Clear executive ownership and board-level visibility are increasingly critical—particularly to align financial incentives and compensation models with the shift of care out of hospital settings.
Care coordination does not happen organically; it requires clear ambulatory ownership.
Governance connects fragmented access points into a cohesive care journey.
Without enterprise alignment, patients are left to coordinate their own care.
Board-level visibility ensures coordination is prioritized—not deprioritized by competing incentives.
Compensation models must reward continuity and coordination—not just volume.
Effective coordination depends on structure—not just capacity.
Ambulatory care—a system command center
Increasingly, ambulatory care functions as the command center of patient navigation and optimization.
This is the nexus of access:
- Where demand is first expressed—often before clinical acuity is fully understood, requiring systems to interpret intent, urgency, and need
- Where patients are routed across care settings—shaping whether care is timely, appropriate, or unnecessarily delayed
- Where continuity is either preserved or lost—with early fragmentation creating downstream inefficiencies that are difficult and costly to correct with risks to patient leakage
High-performing organizations are shifting their focus from expanding access points to orchestrating access pathways. This includes:
- Creating consistent entries across channels—aligning digital, phone, and in-person access into a unified front door rather than disconnected pathways
- Routing patients to the appropriate level of care—matching need to capability and not simply filling the next available appointment
- Reducing unnecessary utilization—actively managing care patterns for stable chronic conditions and low-value visits to preserve access for higher-need patients
- Managing transitions across care settings—coordinating handoffs between primary, specialty, and procedural services to prevent delays and drop-off
Currently, parts of the system depend on patient navigators—but that raises a harder question: in a truly seamless system, should patients need navigation at all?
The reality is that today’s care delivery environment still requires a high degree of orchestration. Dedicated roles have emerged to fill that gap. Patient navigators guide individuals across fragmented care pathways, resolve barriers in real time, and maintain continuity from entry through fulfillment. They take on the logistical complexity of the system, improving the patient experience.
But their necessity also is a signal—not a solution.
A more complete view of access includes three interconnected stages:
- Entry—Can patients easily find, understand, and initiate the right point of care?
- Navigation—Can they move across services without having to coordinate their own care or overcome system friction?
- Fulfillment—Do they ultimately receive the right care within clinically appropriate timeframes?
Most organizations focus on entry. Far fewer address navigation in a coordinated way, and fewer measure whether patients ultimately receive the care they need.
A higher standard of access
The next era of healthcare will not be defined by how much capacity organizations build, but by how effectively they connect patients to that capacity.
According to insights from the Vizient Ambulatory Executives Network, this requires a different way of thinking:
- From sites of care to pathways of care—designing around how patients move, not where services sit
- From local optimization to system orchestration—aligning decisions across departments rather than maximizing individual clinic performance
- From throughput metrics to patient-centered outcomes—focusing on resolution of need, not volume of visits
- From availability to accountability—ensuring capacity translates into timely, appropriate care for every patient
Access becomes the most visible expression of systemness—not just whether services exist, but whether the system functions as an integrated whole.
In practical terms, access must be redefined as:
The ability of a health system to ensure that every individual can enter, navigate, and receive appropriate care—aligned to need and delivered without unnecessary delay or burden.
This is both an operational and ethical standard. It requires not only sufficient capacity, but intentional system design. The organizations that succeed will make access feel less like navigation and more like infrastructure—reliable, responsive, and designed to ensure the smoothest, most appropriate path for every patient.
Access and capacity aren’t just operational challenges—they’re the clearest indicators of what’s really driving (or holding back) performance. Learn about a new Vizient framework to help organizations identify breakdowns and drive meaningful change.
Care is shifting to an ambulatory-first model, but governance often lags behind. Explore how leading systems are redefining scope, aligning leadership and taking enterprise ownership of access.
In this episode of Knowledge on the Go, Tyler Bauer, senior vice president of system ambulatory operations of University of Chicago Medicine, shares how their organization is redesigning ambulatory access to be more connected and intuitive—and what others can learn from their approach.
Learn more about Vizient Member Networks—with 12 C-level networks including ambulatory leaders—that drive healthcare performance improvement to help hospital and healthcare leadership teams accelerate their high-performance journeys.