From Cost Center to Value Engine: Why Patient Access Is a Health System Strategy
Patient access sits at a defining crossroads in healthcare.
Across the country, academic health systems are facing the same pressures: rising demand, limited capacity, workforce strain, and intensifying financial headwinds. In many organizations, access teams feel these pressures acutely—often labeled as cost centers rather than strategic assets, even as they serve as the front door to care.
In a recent episode of The All-Access Pass, Brett Butler, Vice President of Access Services at Baylor Scott & White Health, offered a compelling reframing: access is not a transaction. It is an enterprise strategy.
Fragmentation Is the Enemy of Access. One of the most consistent themes in the conversation was fragmentation. In large, complex academic health systems, access responsibilities are often scattered across ambulatory practices, call centers, capacity management teams, and the business office—each operating with good intent, but rarely as a cohesive whole.
Brett described how access fails not because teams aren’t working hard, but because autonomy without alignment creates silos. The solution, he argues, is not centralization for its own sake, but relationships at scale—a deliberate operating model that connects governance, providers, and operational teams around shared access standards.
At Baylor Scott & White Health, this vision took shape through clinic access partnerships: relationship-based roles that act as the connective tissue between strategy and operational execution. These teams don’t just manage tickets—they build trust, translate standards into practice, and turn access into everyone’s responsibility.
Governance Turns Access into Strategy. Technology alone cannot solve access challenges. Smarter algorithms cannot create appointment slots that do not exist.
What does create sustainable access is governance, explains Brett.
By establishing physician-led access councils, defining enterprise access standards, and pairing those standards with transparent data, Baylor Scott & White Health reframed access decisions as clinical and strategic—not merely operational. Governance became the mechanism that allowed capacity to be created, protected, and sustained over time.
As Brett put it, access is not a side project. It is a daily discipline.
Designing for Demand, Not Convenience. Historically, healthcare has designed access around what works best for the system. Today’s reality demands a reversal.
Rather than starting with its own clinician supply, Baylor Scott & White Health began by understanding demand - how patients seek care, when they need it, and what creates friction along the journey. This shift opened the door to redesigning care delivery itself: blending in-person visits with virtual touchpoints, rethinking follow-up models, and decompressing clinics without sacrificing quality.
The guiding question became simple but powerful: How might we? How might we connect patients to the right care, in the right setting, at the right time?
Technology as Illumination, Not Illusion. In a landscape saturated with promises about artificial intelligence and automation, the conversation offered a grounded perspective. Technology works best when it reveals opportunity - unused capacity, mismatched visit types, referral leakage - rather than pretending to fix broken systems.
Examples like automated waitlists and digital referral pathways demonstrated how technology, paired with governance and workflow discipline, can shorten cycle times, improve predictability for clinicians, and make access feel meaningfully faster for patients.
The Access Leader as the Voice of the Patient. Perhaps the most resonant insight from the episode was this: in the ambulatory enterprise, access leaders are often the clearest voice of the patient in the room.
Patients may only sometimes be patients—but they are always customers. They experience the system not through org charts, but through delays, confusion, and friction. Elevating access means designing around that lived experience, even when it challenges longstanding norms.
When access is treated as strategy, the returns are shared: patients experience care that is more intuitive and equitable, clinicians gain predictability and sustainability, and health systems unlock long-term value.
As Brett framed it, access is not a destination. It is an odyssey—one that requires curiosity, discipline, and the courage to ask:
How might we do this differently?