Access to Continuity-Strategies for Symbiotic Improvement of Access and Continuity of Care

Nathan Hinkle — Tue, 04 Aug 2026 19:27:34 +0000

Date Added:

August 4, 2026

Journal/Publication:

The Journal of the American Board of Family Medicine

Publisher:

The American Board of Family Medicine

Publication Date:

July 28, 2026

Issue:

Volume:

Pages:

1-5

URL:

Access to Continuity-Strategies for Symbiotic Improvement of Access and Continuity of Care

Type:

Practice Management Reviews and Guidelines

Format:

Article

DOI (1):

https://doi.org/10.3122/jabfm.2026.260055R0

Keywords

MeSH

continuity of patient care

leadership

RPR Commentary: Suggestions about how to improve access and continuity simultaneously. James W. Mold, MD, MPH

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Family medicine and primary care face ongoing pressures for access, with demand for care overwhelming the capacity to deliver it. Common strategies to maximize access often operate to the exclusion or detriment of continuity of care. During the August 2025 Family Medicine Leadership Consortium meeting, rather than presuming a tradeoff between the two as inevitable, the proposition that family medicine is committed to improving access to continuity of care was put forth.

This article summarizes concepts and models for improving access that simultaneously preserve or elevate continuity of care. A full understanding of access requires nuanced data around demand and capacity at the day-to-day level. This data can be used to prioritize both access and continuity by incorporating both into appointment templates, right-sizing panels, and directing capacity to the times of greatest demand. Investing in innovative team models such as those incorporating upskilled medical assistants, or panels shared among small teams of physicians and advanced practice practitioners, allow expanded capacity to deliver access while maintaining continuity. Advanced access scheduling models build on foundations of managing demand and capacity to most efficiently match day-to-day visit capacity to demand and maximize access to the continuity clinician.

Improving access and continuity of care do not have to be a zero-sum game—by valuing and centering continuity among access interventions, healthcare systems can shift the paradigm between access and continuity from “either/or” to a symbiotic relationship, with access meaning access to continuity of care.

Author/s:

Kong, Marianna, Lin, Steven, Ramm, Jason D., Weir, Samuel, Newton, Warren P.

The 10 Building Blocks of High-Performing Primary Care

Tracy Ashby — Tue, 09 Apr 2019 05:00:00 +0000

Date Added:

April 9, 2019

Journal/Publication:

Annals of Family Medicine

Publisher:

American Academy of Family Physicians

Publication Date:

March 1, 2014

Issue:

Volume:

Pages:

166-171

URL:

The 10 building blocks of high-performing primary care.

Type:

Practice Management Reviews and Guidelines

Format:

Article

DOI (1):

10.1370/afm.1616.

Keywords

medical

physician’s practice patterns

practice management

primary health care

PMID (1):

24615313

MeSH

primary health care

leadership

continuity of patient care

forecasting

These 10 building blocks of primary care were derived from evaluations of a number of high-functioning primary care practices throughout the country. James W. Mold, MD, MPH

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Our experiences studying exemplar primary care practices, and our work assisting other practices to become more patient centered, led to a formulation of the essential elements of primary care, which we call the 10 building blocks of high-performing primary care. The building blocks include 4 foundational elements-engaged leadership, data-driven improvement, empanelment, and team-based care-that assist the implementation of the other 6 building blocks-patient-team partnership, population management, continuity of care, prompt access to care, comprehensiveness and care coordination, and a template of the future. The building blocks, which represent a synthesis of the innovative thinking that is transforming primary care in the United States, are both a description of existing high-performing practices and a model for improvement.

Author/s:

Bodenheimer, Thomas, Ghorob, Amireh, Willard-Grace, Rachel, Grumbach, Kevin