This document discusses access to health services and identifies it as having three key components: insurance coverage, health services, and timeliness of care. It notes that gaining insurance coverage allows entry into the healthcare system, while accessibility of locations providing care and relationships with providers are also important. Lack of coverage can result in poor health outcomes and medical debt, while having a usual source of care leads to better outcomes and lower costs. Ensuring timely access to appointments and treatments is also important to avoid increased costs and health issues. While access has improved in recent years, disparities still exist for many groups.

1. Steve Trachanas - Access to Health Services
Goal
Improve access to comprehensive, quality health care services.
Overview
Access to comprehensive, quality health care services is important for promoting and maintaining
health, preventing and managing disease, reducing unnecessary disability and premature death, and
achieving health equity for all Americans. This topic area focuses on 3 components of access to care:
insurance coverage, health services, and timeliness of care. When considering access to health care,
it is important to also include oral health care and obtaining necessary prescription drugs.
Why Is Access to Health Services Important?
Access to health services means "the timely use of personal health services to achieve the best
health outcomes."1 It requires 3 distinct steps:
Gaining entry into the health care system (usually through insurance coverage)
Accessing a location where needed health care services are provided (geographic availability)
Finding a health care provider whom the patient trusts and can communicate with (personal
relationship)
Understanding Access to Health Services
The Access to Health Services topic area encompasses 3 components: coverage, services, and
timeliness.

2. Coverage
Health insurance coverage helps patients gain entry into the health care system. Lack of adequate
coverage makes it difficult for people to get the health care they need and, when they do get care,
burdens them with large medical bills. Uninsured people are:
More likely to have poor health status
Less likely to receive medical care
More likely to be diagnosed later
More likely to die prematurely
Services
Improving access to health care services depends in part on ensuring that people have a usual and
ongoing source of care (that is, a provider or facility where one regularly receives care). People with
a usual source of care have better health outcomes, fewer disparities, and lower costs.
Having a primary care provider (PCP) who serves as the usual source of care is especially important.
PCPs can develop meaningful and sustained relationships with patients and provide integrated
services while practicing in the context of family and community. Having a usual PCP is associated
with:
Greater patient trust in the provider
Better patient-provider communication
Increased likelihood that patients will receive appropriate care
Lower mortality from all causes

3. Timeliness
Timeliness is the health care system's ability to provide health care quickly after a need is
recognized. Measures of timeliness include:
Availability of appointments and care for illness or injury when it is needed
Time spent waiting in doctors' offices and emergency departments (EDs)
The delay in time between identifying a need for a specific test or treatment and actually receiving
those services can negatively impact health and costs of care. For example, delays in getting care can
lead to:
Increased emotional distress
Increased complications
Higher treatment costs
Increased hospitalizations
Emerging Issues in Access to Health Services
Over the first half of this decade, as a result of the Patient Protection and Affordable Care Act of
2010, 20 million adults have gained health insurance coverage.23 Yet even as the number of
uninsured has been significantly reduced, millions of Americans still lack coverage. In addition, data
from the Healthy People Midcourse Review demonstrate that there are significant disparities in
access to care by ethnicity, education, and family income. These disparities exist with all levels of
access to care, including health and dental insurance, having an ongoing source of care, and access
to primary care. Disparities also exist by geography, as millions of Americans living in rural areas lack
access to primary care services due to workforce shortages. Future efforts will need to focus on the
deployment of a primary care workforce that is better geographically distributed and trained to
provide culturally competent care to diverse populations.