For the more than 67 million Americans living with disability, significant gaps exist in accessing high-quality healthcare services.1 Research repeatedly demonstrates disparities in health and healthcare outcomes, such as decreased rates of preventative care and difficulties finding an accepting provider.2, 3, 4, 5 For people with disability to begin to access equitable care, healthcare organizations, clinics and providers need to provide disability accessible healthcare.6 Disability accessible healthcare can include accommodations such as wheelchair accessible weight scales, amplifiers for patients with hearing loss, and large print materials for patients with vision disability.7 Additionally, disability accessible care can require modifications in clinic workflows, policies, and procedures, such as offering extended appointment times for patients with disability.

Multiple federal laws explicitly require healthcare organizations to provide disability accessible care, including the Rehabilitation Act of 1973, Americans with Disabilities Act (ADA) of 1990 and Section 1557 of the Affordable Care Act of 2010.2,8, 9, 10 Despite these federal requirements, patients with disability often do not receive the accommodations they require.2 Multiple studies have demonstrated that only a minority of clinics have accessible equipment available.11, 12, 13, 14 A national survey of practicing physicians found that they inconsistently provide accommodations to patients with physical, hearing or visual disability.15, 16, 17, 18

Studies, including a recent systematic review, have explored the factors that contribute to the lack of accessibility in healthcare and have found challenges with negative attitudes and lack of knowledge of healthcare teams as well as the cost of accessible equipment.11,19, 20, 21, 22, 23 Interviews with healthcare organizations report a lack of systems and processes to provide accommodations and education gaps on the part of healthcare leadership and teams contribute to the lack of provision of accessible care.24 These studies have focused on interviewing and surveying physicians and primary care practice managers. To date, no study has comprehensively engaged diverse stakeholders to understand the factors that contribute to the lack of provision of accessible care. The aim of the study was to engage key stakeholders from multiple fields (policymakers, healthcare systems, researchers, and advocates) to understand their perspectives on the role of federal requirements to promote accessibility, as well as explore potential strategies to encourage and incentivize healthcare organizations and clinicians to provide accessible healthcare to patients with disability.