• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer
HSG Advisors

HSG Advisors

Building High-Performing Physician Networks

MENUMENU
  • Home
  • About HSG
    • About HSG
      • Shared Vision
      • Leadership Team
    • Careers
  • Healthcare Consulting
    • Physician Strategy
      • Health System Strategic Plans
      • Employed Physician Network Strategy
      • Physician Growth Strategy
      • Shared Vision and Culture Development
      • Physician Manpower Plans
      • Service Line Strategy
      • Physician Co-Management
    • Physician Leadership
      • Shared Vision and Culture Development
      • Physician Burnout
      • Physician Governance and Leadership
    • Performance Improvement
      • Network Performance Improvement
      • Performance Improvement Implementation
      • Network Revenue Cycle
      • Practice Care Model Transformation
      • Practice Acquisitions
      • Advanced Practice Provider (APP) Utilization
      • Virtual Health
    • Network Integrity
      • Patient Share of Care
      • Patient Flow
      • Provider Service Location Analysis
      • Market Insight
      • Physician Network Intelligence
    • Physician Compensation
      • Compensation Plan Design
      • Fair Market Value and Commercial Reasonableness Opinions
      • Advanced Practice Provider (APP) Compensation
      • Medicare Physician Fee Schedule
  • Thought Leadership
  • Contact Us
  • Medicare Changes
  • Client Log-In
Client Log-In LinkedIn LinkedIn

Contact Us

Five Referral Leakage Metrics Your Network Should Track

Identifying key performance metrics, developing baseline measures, and reviewing metric progress regularly should be common practice within your physician network to help prevent referral leakage.

July 10, 2018 by Wes May

Utilize Claims Data to curtail referral leakage Claims data is being utilized by many healthcare organizations to support strategic initiatives and is often leveraged to develop revenue and market share growth goals. At a more granular level, physician network growth objectives should also be leveraging this level of data. Identifying key performance metrics, developing baseline measures, and reviewing metric progress regularly should be common practice within your physician network to help prevent referral leakage.

Data in this area is overwhelming for many organizations as 25% of all healthcare expenditures in 2016 were from physician clinical services. Knowing where to start with such a large database is often difficult. Prioritization of information that is most relevant to support current strategic initiatives is critical to successfully using claims data and not getting lost in the details.

Below are five strategic metrics we often partner with clients to consistently track and measure to grow physician network volumes and revenue:

  1 

Network Integrity

What percent of unique patient volume stays within your physician network?

You may be quite surprised at the number of patients that interact with your medical staff providers but don’t continue to utilize additional services within your facilities. This metric is a must for your organization.

  2 

Service Line and Specialist Leakage

What percent of unique patient volume that interacts with your specialists receives future services from competitor acute care facilities?

Your specialists should be the highest utilizers of your inpatient and outpatient locations. Do you know what volume of patients you may be losing to local and regional competition that your organization can provide?

  3 

Individual Physician Capture Rates

What percent of unique patient volume remains within your health system for each physician that interacts with your facility?

Physicians on your medical staff or in the community may not be utilizing your services as frequently as you perceive. Understanding current metrics can allow your team to have conversations with individual physicians, identify barriers to facility usage, improve processes for physician’s utilization, and ultimately measure progress over time.

  4 

Primary Care to Specialist Leakage

What percent of unique patient volume from your employed, or medical staff, primary care providers is shared with your employed, or medical staff, specialty providers?

Leakage occurring from primary care to specialist can be detrimental to your health system and should be addressed immediately. Many barriers to primary care providers utilizing specialists within the network are operational in nature and can be overcome.

  5 

Health System “Share of Care”

What percent of volume from patients that interact with your health system is remaining within the system?

This last metric takes a completely different perspective from the previous four and doesn’t measure how physicians are interacting with your facilities but focuses on how patients are interacting with your facilities. This measure may be more difficult to manage long-term but understanding how patients interact with your services will be critical as healthcare continues to transition to a pay-for-performance world.

Physician network growth doesn’t always have to be external and require recruitment or employment of additional physicians. There is most likely significant opportunity for incremental volume capture from physicians currently on your medical staff or practicing in the community. Utilizing claims data appropriately can help your organization sort through the noise, prioritize strategic objectives, and begin growing your physician network.

If you feel your physician network is underperforming due to these metrics, contact us.

Click to download the document
FIVE REFERRAL LEAKAGE METRICS
YOUR NETWORK SHOULD TRACK.pdf
Download a PDF of this article to share with your team

Category iconArticles,  Network Integrity

Primary Sidebar

DJ Sullivan
D.J. Sullivan

(502) 814-1198
djsullivan@hsgadvisors.com

Receive Physician Strategy News

  • This field is for validation purposes and should be left unchanged.

Recent Thought Leadership

  • HSG Claims Data Analytics Updates: February 2023
  • 2023 Medicare Physician Fee Schedule Updates
  • HSG Advisors Expands Consulting Services and Data Analytics Capabilities in Response to National Outpatient Utilization Trend
  • Creating a Win/Win System of Advanced Practice Provider Oversight
  • Employed Provider Network Shared Vision: Process and Intent

Insights for Confident Leaders

Sign Up for HSG's Physician Strategy News™ and Notifications on New Thought Leadership
  • This field is for validation purposes and should be left unchanged.

Footer

9850 Von Allmen Court
Suite 201
Louisville, Kentucky 40241

(502) 814-1180

info@HSGadvisors.com

  • Physician Strategy
  • Physician Leadership
  • Performance Improvement
  • Network Integrity
  • Physician Compensation
  • About HSG
  • Purchase HSG’s Book
  • Leadership Team
  • Careers at HSG
  • Thought Leadership
  • Privacy Policy

Take HSG’s Physician Network Evaluation Survey
Get Started Here

  • LinkedIn
  • Vimeo

© 2023 HSG Advisors. Website managed by SiteCare.com