Many Californians with fair or poor health do not receive timely care1
Timely care results in better treatment adherence, lowers the cost of care, and improves health outcomes. Importantly, timely care allows for early detection and intervention to prevent or treat serious health conditions.2 California has established appointment wait time standards for health plans. The standards require plans to offer an appointment to address urgent health concerns within 2-4 days and non-urgent health concerns within 10-15 days.3 There are shorter wait time requirements for primary care appointments than for specialist appointments.
This indicator tracks the percentage of patients who report receiving outpatient care in a timely manner, for both primary and specialty care. It is a subjective measure of patients’ experience in receiving care that was perceived to be timely, and does not indicate whether they received care within the wait time standards. Data for this indicator comes from the Patient Assessment Survey (PAS), which was sunset in 2024. We hope to identify a comparable data source to continue monitoring this priority area of attention.
Timely Care (Primary Care)
In 2021 (baseline year), 53.6% of patients received primary outpatient care in a timely manner. The most recent data available show 53.6% (2021). There is no target for this indicator because the data source is no longer available.
More Data about Timely Care (Primary Care)
Timely Care (Primary Care)
Caution: The baseline has changed from the original LGHC 2012 Task Force Report due to changes in survey methodology of the data source in 2012.
Baseline
53.6%
Target
-
Timely Care (Specialty Care)
In 2021 (baseline year), 58.8% of patients received specialty outpatient care in a timely manner. The most recent data available show 58.8% (2021). There is no target for this indicator because the data source is no longer available.
More Data about Timely Care (Specialty Care)
Timely Care (Specialty Care)
Caution: The baseline has changed from the original LGHC 2012 Task Force Report due to changes in survey methodology of the data source in 2012.
Baseline
58.8%
Target
-
Indicator Highlights
Delays in care negatively impact morbidity, mortality, and quality of life for patients.2
Patients who are unable to access timely care are more likely to seek care from an emergency department (ED).4
Timely outpatient follow–up after hospital discharge may reduce hospital readmissions for patients with behavioral health conditions.5
Streamlining the prior authorization process can reduce delays in receiving care.6,7
In recent years, California has strengthened its timely access regulations. For a provider network to meet regulatory requirements, 70% of the network’s providers must be able to offer an appointment within wait time standards, and 80% of the network’s non-physician mental health providers must be able to offer a follow-up appointment within the standards.8
Data Snapshot
Low-income Californians have more difficulty accessing timely specialty care.1
Nationally, Black and Latino patient populations experience more barriers to timely care.9
Access to timely care steadily declined from 58.7% for primary care and 62.5% for specialty care in 2016, to 53.6% for primary care and 58.8% for specialty care in 2021. There was a slight increase in 2020 that did not continue through 2021, and may reflect conditions specific to the first year of the COVID-19 pandemic.
Percentage of Patients Receiving Outpatient Care in a Timely Manner, Over Time
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Stories & Solutions
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Clinic in the Park • Connect • Screen • Educate
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The MobileMAMA Text Program: Integrating Medical Care and Social Services for Pregnant Women in the Safety Net
MobileMAMA is a text-messaging program designed to be used by safety-net prenatal patients to provide continuous information to their medical providers about their use of social services in their community.
Vivity – A New Choice in Healthcare Through an Integrated Healthcare System Experience
Vivity is an Anthem Blue Cross health benefit plan that brings together multiple hospital systems to collaborate on clinical quality goals and care coordination to provide members with a virtually integrated delivery system.
The California HealthCare Foundation highlights nine examples of patient-centered programs to reduce readmissions
CHCF highlighted two exemplary California Programs including: 1) Sharp Rees-Stealy Medical Group reduced hospital readmissions and generates a positive return on investment by using nurse case managers to improve the transition of care process for high-risk patients; and 2) Blue Shield of California developed a patient-centered management program that used [...]
Centers for Medicare & Medicaid Services (CMS) has implemented incentives to reduce hospital readmissions
Under the Affordable Care Act, CMS has implemented the Hospital Readmission Reduction Program (HRRP) which aims to reduce preventable hospital admissions by penalizing hospitals with relatively higher rates of Medicare insured readmissions. Since implementation of the HRRP, reducing hospital readmissions has gained traction among providers and policymakers. Evaluating the HRRP [...]
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