Susan Greene and Associates - Strategies to Increase Access To Health Care

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Accessing Specialty & Diagnostic Care

There is growing pressure on community health centers and public hospitals in large urban areas across the country as well as rural areas, to address the issue of access to specialty care. Specialty outpatient medical services are essential to all health care providers and systems. These specialty services are critical in addressing health disparities for poor and minority patients and in assuring the appropriate treatment of disease.

Many safety net systems and providers are heavily made up of chronically ill adults who require access to specialty care to most effectively manage their illnesses. In addition, the broader safety net of private physicians, community hospitals, federally-supported health centers and public health departments have no other option for specialty care for their uninsured patients and either refer directly to the local public hospital specialty clinics or, more often, refer indirectly through the hospital EDs. Finally, the demand on public hospitals for specialty access is growing as other traditional providers of those services, private physicians or academic medical centers, are limiting access to Medicaid covered patients because of decreased reimbursement, or are leaving poor communities altogether.

Restructuring specialty care access and building capacity is one focus of SGA services. Along with other seasoned consultants, SGA has conducted both system-wide assessments of referral patterns and resources as well as look at individual health center’s referral policies and patterns. SGA typically evaluates current programs on-site and referral sources utilized and identifies resources that are underutilized and/or lacking a referral relationship. The goal is to have a rational network of services that match patient need and culture.

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