Issue/opportunity

A $2.5B regional health system was losing patients to competitors despite strong clinical programs. Access constraints (long appointment lead times, limited evening/weekend availability), disjointed scheduling platforms, and low digital visibility led to leakage of high-margin cardiology and oncology patients. The system lacked a cohesive view of where patients originated, where they left, and why.

Approach & outcomes

• Geospatial Access Mapping: Combined claims, EHR, and census data to identify high-demand zip codes with low in-system penetration.
• Access Expansion Model: Designed a hub-and-spoke coverage plan that added urgent access clinics and co-located specialists within PCP offices.
• Scheduling & Referral Redesign: Implemented centralized scheduling, digital self-service booking, and referral routing to the nearest in-network specialty site.
• Digital Front Door Activation: Enhanced online presence, search optimization, and targeted outreach to commercially-insured populations.
• Payer & Employer Alignment: Partnered with top regional payers and employer groups to steer members toward new access points.

Results

• 27% increase in commercially-insured specialty visits.
• 14% reduction in appointment wait times across high-volume specialties.
• 19% decrease in out-of-network leakage within six months of launch.
• Achieved full ROI within nine months through increased downstream revenue and payer incentives.