HEALTHCARE IN THE UNITED STATES
ACCESS ISSUES IN HEALTH CARE
services elsewhere. Other issues may be office culture, operational inefficiencies and inadequate or underuse of resources (IOM, 2015).
All healthcare providers need to switch to a patient-centered approach to care as opposed to the provider-centered method of the past (IOM, 2015). A patient-centered approach may mean having providers available for walk-in appointments—where the patients don’t have to have an appointment—as done in retail clinics. Providers scheduling later office hours and weekends so that individuals might be able to see their regular healthcare provider also promotes a patient-centered approach.
National benchmarks should be evaluated by practitioners to help identify factors that would more closely align their practice with patient-centered care and respect for patients’ time. One benchmark offered by the IOM (2015) is evaluating wait times for all healthcare provider’s office visits. The IOM also suggests evaluating driving times for patients to doctor’s visits.
8.7.3 Telehealth Increasing Access to Care
Telehealth (communication through phone or video), also known as telemedicine, may be a useful resource in a physician practice. According to the IOM (2015), up to 25% of patients call the physician’s office on any given day, and the use of telehealth could curtail an office visit. Utilizing nurses and advanced-practice professionals to help with providing care, health teaching and preventive management, informatics managers, and coordinators of care should be evaluated.
The COVID-19 outbreak may have changed telehealth forever. The Centers for Medicare and Medicaid (CMS) have relaxed the rules for payment to healthcare providers during the COVID-19 pandemic. Telehealth waivers (for both video and phone) from CMS during this national crisis include allowing healthcare providers to perform telehealth visits in rural and non-rural areas, cross state lines, care for established and non-established patients, and bill the same as if the visit were in person (HHS, 2020). Also covered are emergency department visits, initial nursing facility and discharge visits, home visits, and therapy visits. Federally Qualified Health Centers and Rural Health Clinics have also been added to provide telehealth sites at a distance or to arrange telehealth services for those unable to travel (HHS, 2020), thereby possibly reaching those who are disadvantaged. With the use of telehealth expansion, especially for Federally Qualified Health Centers and Rural Health Clinics during COVID-19, hopefully payment for these services can continue so that all persons can easily access a healthcare provider and in a timely manner.
8.8 SUMMARY
This chapter discussed variables and statistics related to access to healthcare, barriers of access and utilization of healthcare services, problems associated with lack of access, and possible measures going forward. Considering the statistics
Page | 176