Time is of the Essence: Schedule with Intention

By Elizabeth Woodcock, DrPH, MBA, FACMPE, CPC

As with any complex, multi-faceted process, there are opportunities to improve scheduling. Calls may be processed by a health care organization with ease, but if there is nowhere to put the patient – that is, no appointment slot available – then picking up the telephone matters none.

The appointment template is the backbone of an ambulatory practice. Time – the provider’s time – is a practice's greatest asset and must be proffered with care as time represents a single product, perishable inventory. Furthermore, the inventory, which may be considered “supply,” must be thoughtfully matched with demand. Equilibrium is achieved when the supply of providers is matched with the demand of patients – delivering the right care at the right time and in the right place. 

An airplane, with its seats to sell and fill, offers an excellent analogy. Like the ambulatory enterprise of a healthcare organization, the airplane carries a tremendous amount of fixed costs, and is more profitable as its seats fill. Furthermore, the ticketing process is dynamic for an airplane. Seats are filling and emptying all the way up to the departure of the plane, even being oversold in many cases by the airline to reduce the risk of leaving with an empty seat knowing they can offer a voucher should everyone arrive. Unlike Delta, United, American, or another airline, however, pricing cannot be used as a lever to improve the matching of supply and demand for a healthcare organization. Providers are price takers with a fixed rate of reimbursement for the visit. This dynamic disables the ability for healthcare organizations to use pricing as a strategy to achieve equilibrium, leaving the organization with no viable option to effectively decant an overbooked schedule. 

Despite the inability to use pricing to match supply and demand, a healthcare organization can – with intention – increase the utilization of its single product, perishable inventory – the billable provider’s time. This can be accomplished with strategic booking, but only if templates are well designed. Attention to the schedule is of import in light of changing consumer behavior – patients and referring providers are less tolerant of waits, and increased financial responsibility has resulted in higher expectations for service and accessibility. In this regard, price, or rather the "cost of doing business with the system," clears the market by pushing patients toward healthcare organizations that are most well-equipped to deliver a high level of accessibility.

In sum, it’s no longer possible to assume that a patient will eventually get an appointment; this dynamic must be managed.

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