Access as a Value Driver: Connecting Access to Value-Based Care

Ambulatory access has long been framed as an operational function. Answer the phones. Send appointment reminders. Fill the schedule. Reduce no-shows. But what if we have been underestimating its value?

Across health systems, access leaders are performing work that directly improves outcomes, reduces unnecessary utilization, and strengthens performance under value-based arrangements. The challenge is not the work itself. It is how that work is positioned – and recognized.

Too often, efforts to improve the performance of ambulatory access are internally focused. We work to improve workflows, redesign templates, and streamline intake. And in many cases, we encounter resistance along the way. Stakeholders question the changes – after all, there are decades of experience in the workstreams that exist. As these changes are occurring in reducing barriers to access for patients and families, value-based care conversations are happening in parallel. These discussions are often led by population health or contracting teams - and typically focused on specific payer populations.

What is missing is the connection between these two worlds. Because the reality is this: access is not separate from value-based care. It is foundational to it.

In a recent discussion with experienced leaders, this disconnect came into sharp focus. On one side, access leaders are working to close care gaps, improve timeliness to specialty care, manage post-discharge follow-up, and help patients navigate to the most appropriate setting. On the other, payers are designing programs to achieve those exact same outcomes.

Yet the work is rarely translated into a shared language. Dr. Stephanie Mills, founder of consulting firm atelierHealth and former Executive Vice President of Health Service and CMO of Louisiana Blue, joined the conversation to elucidate the payer’s perspective. Value-based programs are built around measurable impact. Not activity, but outcomes. Improved preventive care rates. Reduced emergency department utilization. Lower hospital readmission rates. Better chronic disease management. These are the metrics that matter, reveals Dr. Mills.

As access leaders know, these elements are directly influenced by access. The challenge is that most health systems are reacting to payer-designed programs, rather than proactively bringing attention to the value they are already creating. As Dr. Michael Kraft, Emory Healthcare’s Vice President of Clinical Performance & Operational Excellence, explained, we are often “responding to the program” instead of shaping it.

What would it look like to flip that dynamic? At Emory Healthcare, one example offers a glimpse into what is possible. Faced with low completion rates for annual wellness visits (AWVs) among Medicare patients, Dr. Kraft and his team did not start by adding more capacity. Instead, they redesigned access to those visits. Leveraging his former role as Associate Chief Health Information Officer (CHIO), Dr. Kraft advocated for pushing questionnaires directly to patients, simplifying documentation for clinicians, and leveraging the electronic health record to highlight only what required attention, thereby removing friction from the process. Within 12 months, completion rates of AWVs astoundingly increased from 30 percent to 84 percent.

But the real story is what followed.

Higher completion rates led to improved identification of care gaps, increased preventive screenings, and better performance across quality measures. In parallel, more accurate documentation improved diagnostic accuracy and reflected better management of chronic conditions. The result was not just better patient care, but significant financial return tied to value-based performance. Emory Healthcare’s CMS Star Rating skyrocketed – and, as stakeholders saw results, this single initiative led to dozens more.

This is the intersection we have been missing.

Access is not just about getting patients in the door. It is about ensuring they receive the right care, at the right time, in the right place. When designed effectively, it becomes a mechanism for managing populations, not just schedules. And yet, many access leaders are not at the table when value-based strategies are defined. Part of the challenge is structural. Health systems are typically organized around contracting efforts that are aligned to specific payers, while access teams are responsible for all patients. Academic health systems, in particular, have limited a primary care footprint, making it more difficult to see where they fit into traditional value-based models, which are largely rooted in primary care. But this is exactly where the opportunity lies.

Specialty care access, care coordination, and transitions of care in the low-cost ambulatory setting are increasingly central to value. Timely access to specialty services prevents unnecessary emergency department visits. Efficient post-discharge follow-up reduces hospital readmissions. Virtual care expands capacity without adding physical resources.

These are not theoretical concepts. They are operational realities already being executed across health systems. The next step is to make that work visible and valued. That begins with connecting access efforts to outcomes. Not just what is being done, but what it produces. Natalie McCall, MSHCT, a principal with atelierHealth explores: Where are care gaps being closed? Where is high-cost utilization being avoided? Where is timeliness improving patient outcomes? Where is health being managed?

From there, the work must be translated into the language of value. Financial impact matters. Whether through shared savings, care gap closure, condition management, care coordination, or avoided cost, the ability to quantify contribution changes the conversation.

And finally, access leaders have an opportunity to be more proactive. Rather than waiting for payer-defined programs, there is a path for access leaders to bring forward a clear value proposition at the negotiation table. In its simplest form, that could be a concise articulation of how access initiatives improve outcomes, supported by data and aligned to payer priorities.

This is not about changing the work itself. It is about reframing it. When positioned correctly, access becomes a lever for improving quality and safety, reducing cost - and delivering on the promise of value-based care. The work is already happening. The opportunity now is to ensure it is recognized, measured, and brought to the forefront of the conversation.

Join the conversation: atelierHealth’s Dr. Mills (linkedin.com/in/stephanie-mills-mdmhcm) and Ms. McCall join Dr. Kraft of Emory Healthcare as our guests for the Patient Access Collaborative’s All-Access Pass to Access podcast.