Livonia, Mich.-based Trinity Health is working to make primary care, rather than the emergency department, the main way patients enter its system, executives said during the system’s fiscal 2026 investor call Oct. 26.
Health systems have historically treated the emergency department as the primary entry point to care, said Ray Anderson, PhD, executive vice president and chief strategy officer.
“We’re looking to flip that pyramid upside down and really have primary care be the most important entry point,” he said.
Dr. Anderson said routing patients from primary care to specialists and then to community-based services brings in more elective patients who are “choosing us,” creates a more balanced payer mix and makes the system less dependent on seasonal swings in emergency volumes.
Trinity is also trying to make care easier to navigate once patients are in. COO Dan Roth, MD, said the healthcare industry, Trinity included, “does not deliver a truly connected experience.”
“We leave many people disappointed with access and leaving them to guide their own care,” Dr. Roth said.
Here are four ways the 88-hospital Catholic system is rebuilding its front door:
1. Growing primary care. Trinity expects to reach 2.4 million primary care members in fiscal 2027. It signed or started 127 new primary care providers in fiscal 2026, which ended June 30. The system plans to add 100 more in fiscal 2027, according to its presentation. Dr. Roth said the system is opening new access points closer to the communities it serves and recruiting nationally.
2. One front door and one record. Trinity’s plan to connect care includes one front door to access, one patient record, a shared care plan, closed-loop referrals, navigation built into care and proactive outreach, according to its presentation. Through its Epic system, patients booked 3.9 million appointments online in 2025, and 43,000 appointments were booked through a FastPass feature that let patients be seen an average of 22 days sooner. Trinity also plans to double use of MyChart Bedside for hospitalized patients in fiscal 2027.
3. Listening to patients and closing the loop. Dr. Roth said Trinity surveyed hundreds of thousands of patients over the past year. They said their relationships with their physicians drive loyalty and trust, and they dislike friction in scheduling, access and navigating the system. Trinity’s medical groups now follow up with patients who give low scores to address their concerns, which Dr. Roth said helped the groups reach a net promoter score of 90 in the last six months of fiscal 2026. Emergency department scores rose from 34 in fiscal 2023 to 49 in fiscal 2026.
4. Keeping patients who lose coverage out of the ED. “As people lose their insurance coverage, we want to make sure they have access to the right care at the right time,” Dr. Roth said. Trinity is investing in care before, during and after emergency department visits to steer patients to the right setting and avoid repeat visits for nonemergency care. It will measure success by reductions in avoidable, low-acuity self-pay ED visits and frequent ED users.
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