Industry Insights 2025: The New Imperative for Patient Access Leadership

By Molly Siegel, MPH, Senior Associate, Patient Access Collaborative

At a time when nearly every health system across the nation is grappling with worsening wait times, thinning margins, and escalating consumer expectations, the case for rethinking patient access has never been more urgent. In her presentation to the Patient Access Collaborative’s industry partners, Executive Director Dr. Elizabeth Woodcock shared a comprehensive look at the forces reshaping ambulatory care—and the bold response our members are mounting.

Dr. Woodcock illuminated the latest data trends, clarified persistent misconceptions about access, and issued a compelling call to reframe access leadership as a strategic, system-wide priority. Here are key takeaways from the session.

The Definition of Access Is Evolving

It’s tempting to think of “patient access” as synonymous with hospital admissions or centralized scheduling, but Woodcock emphasized that this traditional framing is dangerously outdated. Based on the Collaborative’s recent academic publication, she defined access as:

“The ability to simplify the health system for patients, offer timely care, and connect patients to their care providers.”

That means three essential ingredients—frictionless navigation, timeliness, and connection—must be present to truly achieve access. This definition reflects a shift from transactional scheduling to a more holistic model of care coordination, health equity, and population engagement.

Five Structural Forces Are Fueling an Access Crisis

Why are so many access leaders struggling to keep up, even as demand remains high? According to Woodcock, there are five foundational forces:

1. Complexity of the System: Subspecialization has exploded in medicine. Nearly 90% of internal medicine residents, for example, are now pursuing fellowships. This lengthens training pipelines and narrows patient panels, exacerbating fragmentation and access barriers.

2. Supply-Demand Imbalance: The U.S. healthcare system is facing a projected physician shortfall of 86,000 by 2036, according to the AAMC. Clinicians are experiencing high rates of burnout. In ambulatory care, demand is surging while clinical workforce capacity is shrinking—a recipe for gridlock. 

3. Misaligned Reimbursement: Reimbursement still favors acute care settings. ED visits are paid at five times the rate of outpatient care, disincentivizing investment in preventative, team-based, and digitally enabled ambulatory access.

4. Technological Change: As health systems add chat tools, bidirectional texting, and self-scheduling, access teams are increasingly managing not just scheduling but the full spectrum of patient communication—without proportional resources.

5. Consumer Expectations: Patients now expect seamless, Amazon-like experiences. Meanwhile, the average primary care physician receives over 15 in-basket messages per hour, most of which go unreimbursed.

These forces interact and compound, placing immense strain on operations and demanding new leadership models grounded in system-level thinking.

Visibility Matters: The Power of Concentric Circles

One of the most powerful visuals from the presentation was a set of concentric circles showing what the Patient Access Collaborative calls the “visible” and “invisible” sides of demand. Most systems track completed visits, but fail to fully measure:

• Non-arrivals (patients who had appointments but didn’t arrive – and the method and horizon that they informed the system about not coming)
• Inbound referrals that never convert (often paper-based and untracked)
• Unexpressed community need (language barriers, digital exclusion, care gaps)

By focusing only on the center—completed appointments—health systems suffer from a dangerous case of survivorship bias. The consequences go beyond missed revenue. As Woodcock noted, “This is a patient safety issue.”

Centralization Isn’t About Control—It’s About Systemness

Historically, scheduling lived in silos—within departments, divisions, or even individual provider practices. Today, forward-looking systems are transitioning toward centralized access operations. This shift allows for:

• Load balancing across the network
• Visibility into slot utilization
• Standardization of templates and rules
• First-call resolution for patients 

Woodcock likened these centralized teams to “air traffic controllers,” orchestrating patient flow and ensuring that access is equitable, efficient, and aligned with system growth objectives.

Digital Access Has a Downside—If Unmanaged

Self-scheduling, chatbots, and digital front doors offer enormous promise. But without the operational infrastructure to manage them, they can create new problems. For instance, self-scheduling has led to higher cancellation rates—a finding that Woodcock discovered in her doctoral research.

“When we give patients 24/7 tools to cancel appointments,” she explained, “they’re more likely to use them. And if no one is managing the dynamic schedule on the back end, that parachute effect creates real chaos.”

Technology, in other words, is not a silver bullet. It must be paired with workforce planning, intelligent template design, and real-time analytics to truly enhance access.

Access Is Strategy

Perhaps the most important insight from the session was this: access is no longer an operational function alone. Access is a strategic imperative.

• Financial: outpatient revenue now exceeds inpatient revenue for the first time in U.S. history.
• Competitive advantage: health systems that ignore access risk losing commercially insured patients to competitors who offer more timely, convenient care.
• Policy: regulatory and reimbursement pressures—including a $1 trillion federal cut to healthcare spending—will disproportionately impact the underinsured, magnifying the importance of efficient, equitable access systems.

In response, some PAC members are elevating access leadership to the VP or SVP level. Others are integrating access teams into enterprise strategy and transformation offices. As Woodcock noted, “We’re no longer just the front door. We are the health system’s growth engine.”

Looking Ahead: A New Framework for Change

The presentation concluded with a preview of the Patient Access Collaborative’s Access Framework, the first evidence-based model to define the structures and processes needed for access excellence. Core capabilities include:

• Contact center optimization
• Capacity and template management
• Referral conversion
• Digital value management
• Pre-service revenue cycle integration
• Real-time access analytics

Together, these capabilities form the foundation for access strategies that are reliable, scalable, and sustainable.

Final Thoughts

The challenges facing health systems in 2025 are profound—but so is the opportunity. As Dr. Woodcock emphasized, access teams are no longer simply schedulers or call center operators. They are ambassadors of the patient experience, drivers of system growth, and guardians of community connection.

For industry partners, this evolution demands a new level of empathy, evidence, and design thinking. Selling a solution to an access leader today means understanding the complexity of their environment and aligning your product to the strategic challenges they face.

Because in the end, patient access isn’t just an operational issue—it’s healthcare’s front line.

On behalf of the Patient Access Collaborative, we thank our industry partners for their support: ClearTriage, Genesys, Hyro, Luma, NotifyMD, Qgenda, and T2Flex.

Don't miss our Industry Partner Showcase happening on Thursday, November 6. Click Here to Register!