mckinsey-破解医疗服务可及性难题 Solving the healthcare access challenge

February2026

Mckunsey

&company

HealthcarePractice

Solvingthehealthcareaccesschallenge

Expandingaccesstakesmorethanaddingcapacity—organizationsmustensuretherightcare,intherightplace,andattherighttimetoimproveoutcomesandclinicianretention.

byLauraMedford-Davis

withConnorSoares,EmilySchlichtingDemres,andSarahGreenberg

Solvingthehealthcareaccesschallenge2

Accessdelayediscaredenied.Acrossthehealthcareecosystem,patientsarewaiting—often

toolong—forappointments,specialists,andanswers.Inthe2025McKinseyPhysicianSurvey,

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83percentofsurveyedphysicianssaythatthey’veseenpatientspostponecare.Accessbarrierscomprisedthreeofthetopfivereasons,accordingtorespondents.

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Eachdelayriskspoorer

outcomes,highercosts,andgrowingfrustrationforpatientsandclinicians.

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Careorganizationsgloballyrecognizethatimprovingpatientaccessisbothurgentanddifficult.Theyhavetypicallytriedtosolvetheissuebyaskingdoctorstobemoreproductiveandhiringmorephysicians.Butamid

ongoingphysicianshortages

—projectedtoexceed137,000by2037intheUnitedStatesalone

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—askingphysiciansto“domore”intoday’senvironmentrisks

exacerbatingburnoutandworseningaccess.

Organizationshavealsoconcentratedonreducingwastedcarecapacitybyredesigningclinic-schedulingtemplatesandremindingpatientsoftheirappointmentstopreventno-shows.Whilereducingwasteremainsimportanttoincreasingaccess,itistablestakesandonitsownfalls

shortofmeetingpatients’needsasdemandrisesandpatientexpectationsevolve.

Hence,thisarticlegoesbeyondwastereductiontooutlinethreeadditionalsolutionsthatbuildontheseefforts:reimaginecaremodelstounlockcapacity,incorporatepatientpreferencestocatalyzeadoptionofthenewcaremodels,andexpandcapacitytoscalesustainably.

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Allfourtogetherrepresentamoreinnovativeapproachtoensuringpatientsgettherightcare,intherightplace,attherighttime.Whenimplementedtogetherandintherightsequence,these

solutionscanaddthreetosevenpercentagepointsofEBITDAmarginwhilealsoimprovingsatisfactionandretentionforpatientsandcliniciansalike,aswellashealthoutcomes.

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Reimaginecaredeliverywithexpandedcareteamsand

transformationalcaremodels

Thefirststeptofixingtheaccesschallengeistorethinkhowcareteamsandpatientcaremodelsarestructured:whodeliverscare,where,andatwhatacuitylevel.

Today’spatientsincreasinglyhavecomplexchronicneeds,whicharenotmetbytraditional

single-physiciancaremodels.Administrativeburdenandfragmentedinformationfurtherlimitwhatanyonephysiciancanmanagealone.Inaddition,successinreimaginingcaredeliveryhasbeenchallengedbythesubstantialinvestmentsrequired—bothintechnologyandAIandinthetimerequiredforchangemanagement.Forchangetostick,detailedclarificationand

subsequentretrainingofthedailyresponsibilitiesandworkflowsofeachin-clinicand

centralizedroleareneeded.Thepayoffisstrongercommunityhealthandbetterexperiencesforpatientsandclinicians.

Tosolvethesechallenges,focusingontwotacticsiskey:comprehensivelydefiningcaremodelsandclinicalteams,andboostingstaffingandtechnologicalenablement.

1The2025McKinseyPhysicianSurveywasinthefieldfromMay27toJune30andgarnered650responsesacrossthesurvey.

2The2025McKinseyPhysicianSurveywasinthefieldfromMay27toJune30andgarnered650responsestothequestion“Haveyouseenthatyourpatientsaredelayingnecessarycare(duetofinancialconcerns,missedappointments,longwaittimesfor

referralsorprocedures,etcetera)?”and540responsestothequestion“Whyareyouseeingyourpatientsdelaynecessarycare?”

3MichaelBondetal.,“Theinfluenceofwaittimeonsurgicaloutcomesinelectivelumbardegenerativespineconditions:Aretrospectivemulticentrecohortstudy,”GlobalSpineJournal,May2025,Volume15,Number4.

4Workforceprojections2037,HRSADataWarehouse,December18,2025.

5Thisarticledoesnotconstituteclinical,legal,policy,orotherregulatedadvice.

6Marginavailabilitydependsonlevelsofunmetdemandinthecommunity.

Solvingthehealthcareaccesschallenge3

Definecaremodelsandtheclinicalteamstodeliverthem

Physician-ledteamsmust

definethecaremodels

neededtodelivertherightcare,intherightplace,attherighttime.Thisbeginswithidentifyingpatients’baselineclinicalneedstoensuretheyareroutedappropriatelyasnewissuesarise,therebyensuringthateachvisitdeliversthegreatestvalue.Whenvisitsarepoorlypreparedormisrouted—suchaswhenrequired

diagnosticsaremissingorwhenpatientsseeaspecialistunnecessarily—careisdelayednotonlyforthatpatientbutalsoforotherswaitingforsimilarservices.Conservatively,10to30

percentofadoctor’sscheduleisspentonpatientvisitswherecarewaseitherunnecessaryorcouldhavebeenmanagedmoreeffectively,ourresearchshows.Andinour2025Physician

Survey,respondentsonaveragenotethat42percentofthetimetheyspendonpatientcarecouldbedelegatedtoothercareteammembers,

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reallocatingscarcephysiciantimetothe

highest-valuedemands.

Often,patientscanbeseenbyothersontheirphysician’scareteamwithoutcompromising

quality,includingadvanced-practiceclinicians(APCs)toaddresssomeclinicalneedsand

communityhealthworkerstomanagesocialchallenges.Whilestatelicensureregulationsdefinetheboundariesofwhatispossible,morecareisaccessiblewhencliniciansoperateatthetopoftheirlicense.Forexample,ifAPCsprovidemorepre-andpost-opcare,surgeonscanincreaseoperatingtimeandthusexpandtotalpatientaccesstosurgery.

Specialtyco-managementisanotherhigh-impactapproachtoensureoptimalvalueforeachspecialistvisit.Forexample,patientswithstable,uncomplicatedhypertensioncanoftenbe

managedbytheirprimarycareprovider(PCP)ratherthanacardiologist.Thisfreescardiologycapacityforpatientswithmoreacuteorcomplexneedswhobenefitmostfromrapidspecialtyaccess.

Providestaffingandtechnologysupport

Apatient’scareteamshouldalsocomprisearangeofprofessionalsandtechnologytosupportclinicians’administrativework.Physicianrespondentstothe2025surveynotespending11

percentoftheirclinicaltimeonchartinganddocumentation,

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andthe2023McKinseyNursingPulseSurveysuggeststhattechenablementcouldfreeabout20percentofnurses’timefordirectpatientcare.

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High-potentialusecasesforcentralization,automation,andtechenablementincludeAIscribes,in-basketmanagement,medicationrefills,previsitplanning,priorauthorization,quality

reporting,andreferralmanagement.

Limitingtake-homeandnonpatientcareactivitiescan

addressburnout

—reportedby35percentofrespondentsinthe2025physiciansurvey

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—whichensurescliniciansaremoreengagedwithmeaningfulworkatthetopoftheirlicense.

Addresspatients’preferencesonanindividualbasis

Caremodelstranslateintoimprovedaccessonlywhenpatientsreceivecarethat’stailoredtotheirindividualneeds.Personalizationisessentialthroughoutthepatientjourney,anditstartswithscheduling.

7The2025McKinseyPhysicianSurveywasinthefieldfromMay27toJune30andgarnered528responsestothequestion“Forthefollowingpatientcareactivities,pleaseindicatewhatpercentofthetotaltimespentonallrelatedtasksthatcouldbe

completedbyeachcareteammember,ifeveryteammemberwasstaffed,well-trained,andpracticingatthe‘topoftheirlicense,’thatis,tasksmaximallyshiftedtothelowest-trainedcareteammember.”

8The2025McKinseyNursingPulseSurveywasinthefieldfromJanuary10toFebruary17,2025,andgarnered650responsestothequestion“Whatpercentageofyourpatientcarehours,whichincludespatient-facingandnon-patient-facingtimebutdoes

notincludeadministration,research,orteaching,doyouspendonthefollowingactivitiestoday?”

9The2023McKinseyPulseSurveywasinthefieldfromFebruary8toMarch22,2023,andgarnered240responsestothequestion“Foratypicalshift,howmanyminutesdoyouspendoneachofthefollowingactivities?”

10The2025McKinseyPhysicianSurveywasinthefieldMay27toJune30andgarnered650responsestothequestion“Overall,howwouldyourateyourlevelofburnout?”

Solvingthehealthcareaccesschallenge4

Yetakeychallengehasbeenthattraditionalschedulingoptimization,suchasreminders,

double-booking,andtemplateoptimization,hasonlygonesofar.Thesetacticsarelargely

supply-drivenandstatic,offeringlimitedflexibilityaspatientneedsevolveandcareteams

expand.Next-generationtacticsuseadigitalfrontdoororomnichannelapproachthatincludespersonalizingpatientengagementtomeetbothpatients’“felt”(asdefinedbelow)andclinical

needs,andbuildinganintegrationlayerintothetechnologystacktohardwirepatients’

preferencesandnewcaremodelsintotheschedulingprocessandtoensureoptimaluseofexistingcapacity.

SegmentpatientsbasednotonlyonclinicalneedsbutalsoonconsumerpreferencesThemosteffectivecaremodelsdeliversuperioroutcomesandpatientexperiencebyintegratingapatient’sclinicalneedswiththeirfeltneeds—consumerpreferences,includingbehaviors,

mindsets,andself-identity.Reminders,clinicalrecommendations,andadministrativeoutreachcanallbepersonalizedthroughsegmentation-drivenalgorithmsandscripts(table).When

engagementresonateswithfeltneeds,careteamsaremoresuccessfulatguidingpatientstotherightcare,intherightplace,attherighttime.

Solvingthehealthcareaccesschallenge5

Whenpreferencesdivergefromclinicalneeds—forexample,whenapatientwantstoseeaspecialistinsteadofaPCPoraphysicianinsteadofanAPCorregisterednurse(RN)—theirexpectationsneedtobeaddressed.Thegoalisnottorestrictchoicebuttoguidepatients’decisionswithtrustand

transparency.Onemethodistoincludethepatient’sdoctorofchoiceinafirstappointmentto

introducetheothercareteammembers.Ultimately,patientsmustretaintherighttoschedulethecaretheyprefer,evenwhenitdiffersfromwhattheirclinicalsegmentsuggests.

Hardwirehyperpersonalizedschedulingforsustainedsuccess

Todeliverconsistent,personalizedexperiencesacrosstouchpoints,clinicalandconsumersegmentsmustbehardwireddirectlyintooperations.Anintegrationlayercanconnectasinglepatientprofiletotheirelectronichealthrecord(EHR)andallengagementchannels(patientportalonprovider

website,etcetera).Allpatient-facingemployeesalsoneedtobetrainedtodeliverpatient-centered,personalizedmessaging.

Forexample,whenapatientschedulesanappointment(whetheronlineorbyphone),thesystem

canprioritizeoptionsbasedonindividualneedsandpreferences.Thesecapabilitiesshouldextend

beyondphysicianvisitstoincludeimaging,labs,procedures,andotherancillaryservices,ensuring

theentirepatientjourneyiscoordinatedandefficient.AsdigitalandAI-enabledschedulingtoolsareincreasinglyused,organizationsmustcommittomonitoringforbiasinroutingoutcomesandwait

timestoensureequitablecare.

Expandthecapacityavailableforcare

Themethodstoexpandactualcapacitycanbegroupedintotwocategories:people(cliniciansandclinicalstaff)andspaces(physicalsitesandvirtualsettings).

Reimaginingcaredeliveryandpersonalizingschedulingworkflowscanexpandaccess,but

withoutcapacityanddemandplanning,theyriskamplifyingexistingconstraintsandinefficiencies.Becauseexpandingcapacityisbothacapital-andpeople-intensivechallenge,itmayenhancenetpatientservicerevenueattheexpenseofoperatingmarginsiftheothertwosolutionsarenot

optimizedfirst.Andsinceexpandingactualcapacityisthemoststraightforwardsolution,manyorganizationsmistakenlystarttheiraccessexpansionthere.

Toovercomethesechallenges,anorganization’sstrategicgrowthplanshouldaddressreimaginedcaremodelsandtheclinicalandconsumerneedsofitscurrentandtargetpatientpopulation.Forexample,organizationsservingortargetingahighproportionoflow-complexitypatientswho

preferdigitalengagementmayprioritizevirtual-careinvestmentsovernewsites.

Whennewsitesareneeded,theexactworkforce,buildspecifications,andlocationsshouldbe

carefullyconsideredtoaddressknowncapacity–demandmismatches.Forexample,aworkforceplanthatdoublesortriplescarecapacitymayrequireminimalnewphysiciansandspecialists,butatleastadoublingofAPC,nursing,caremanagement,andtechnicianroles.

Bothsynchronous(forexample,videooraudiotelehealth)andasynchronous(forinstance,

provider-to-providere-consults)virtualcarecanexpandcapacity.Physiciansrespondingtothe

2025surveyreportseeing18percentmorepatientsperhourthroughvirtualcarecomparedwithin-personcare.

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Deliveringcarethroughdedicatedvirtualsessions—conductedoutsidetraditionalexamroomsandscheduledinhalf-orfull-dayblocksthataredistinctfromin-personcare—can

alsoreducecapitalrequirements.Whenalignedtoapatient’sclinicalneedsandconsumerpreferences,theconvenienceofatelehealthvisitcanfurtherenhancepatientsatisfaction.

11The2025McKinseyPhysicianSurveywasinthefieldfromMay27toJune30andgarnered253responsestothequestion“Onaverage,howmanypatientscanyouseeperhourthroughtelehealthversusin-person,whenyoudedicatethefullhour(60

minutes)toeitherallface-to-facevisits,ortoalltelehealthvisits?”andwaslimitedtothe39percentofphysicianswhoreportspendingatleast1percentofclinicaltimeprovidingvirtual/telehealthcare.

Solvingthehealthcareaccesschallenge6

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