Enhancing Access in Academic Medical Centers Through Incentive-Based Evening and Weekend Clinics

Area of Science:

• Healthcare Management
• Ambulatory Care Services
• Physician Workforce Wellness

Background:

• Academic medical centers face significant challenges in providing timely ambulatory care access.
• Extended clinic hours are crucial for meeting patient demand and improving healthcare delivery.
• Physician work-life balance is a key consideration in healthcare operational models.

Purpose of the Study:

• To evaluate the impact of the Access Plus program on patient wait times and physician engagement.
• To assess the financial viability and downstream revenue generation of extended ambulatory care hours.
• To determine the feasibility of balancing physician preferences with organizational goals for improved patient access.

Main Methods:

• Implementation of the Access Plus program, offering extended evening and weekend hours for physicians with enhanced compensation.
• Targeting new patient appointments and UC Davis Health employees/families for expanded access.
• Strategic focus on physician and employee support to drive initiative adoption and success.

Main Results:

• A median reduction of 21 days in wait times for new patients was achieved.
• 17.3% of eligible physicians (138 out of 800) participated in the program.
• The program generated $13.3 million in total contribution margin, despite being cost-neutral initially.

Conclusions:

• Well-designed programs can successfully extend traditional operating hours in academic health systems.
• Balancing physician preferences with organizational goals enhances patient access and physician acceptance.
• This model provides a scalable approach for other health systems to improve ambulatory care delivery and workforce engagement.