Patient Share of Care: The Revenue-Based Metric Every Health System Needs

Read the full article as originally posted by Becker’s Hospital Review

Despite the financial blows delivered to the country’s healthcare systems during the past two years, many organizations continue to operate in a predominantly fee-for-volume environment while slowly transitioning towards a value-based care model. However, it’s well known that you can’t ride two horses at the same time. This idiom holds true in healthcare as systems struggle to flip the healthcare paradigm from volume to value. Uniform patient growth and retention strategies simply can’t thrive in care environments with divergent business models. 

Fee-for-volume is focused solely on attracting and pushing more patients through the system while Fee-for-value strives to manage the care of a specific population in a more cost-effective and quality manner. Because most organizations can’t simply switch from volume to value overnight, they must learn to survive in both worlds. Organizations must have strategies in place to support both business models. Patient attraction strategies will support organizations continuing to thrive in today’s current fee-for-volume environment. Patient retention strategies support the latter.

At the height of the pandemic in 2020, more than 40% of patients opted to forego medical treatment. Empty waiting rooms and temporarily closed practices were commonplace. Today, as the population adapts to living with COVID as part of our daily experience, health systems are working hard to recover and retain their patients. In support of this recovery, HSG, a respected national healthcare consultancy, is providing healthcare organizations with best practices for measuring, reporting, and building strategies around patient share of care. HSG Patient Share of Care™ is a revenue-based metric that comprehensively evaluates the total spend of a patient on their healthcare services (inpatient, outpatient, ambulatory, physician office, etc.). This is an expanded offering of HSG’s successful Healthcare Network Integrity service line.

HSG Patient Share of Care helps health system executives build a comprehensive view of patient activity within their market and enables health systems to answer questions such as:

  1. Where are the largest gaps in overall patient retention?
  2. When patients leave our system for any service (inpatient or ambulatory), what competitive providers, health systems or other services do they seek?
  3. How does patient retention differ at each of the following levels?
    • Geographically (Figure 1)
    • Individual service and sub-service lines (Figure 2)
    • Individual primary practices and/or providers
    • Patient access points (inpatient, outpatient, emergency, urgent care, physician office, etc.) (Figure 3)

4. How brand loyal are patients to our entire health system?

5. What are our biggest opportunities to improve patient retention?

Share of Wallet

To find out more about your healthcare organization’s patient share of care, contact the healthcare business experts at HSG.

This article was originally published by Becker’s Hospital Review on February 1, 2022.

Read the full length article here.
Outpatient Market Share for All Kentucky Hospitals Share of Wallet White Paper

D.J. Sullivan

Chief Strategy Officer and Managing Director of Claims Data Analytics