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A recent health system client with 15+ community hospitals and flagship academic center sought to more clearly understand patient retention as it applied specifically to their employed primary care providers. By studying Patient Share of Care at the service line and provider levels, the health system intended to gauge the effectiveness of recent and planned patient retention strategies. 

HSG PATIENT SHARE OF CARE PROCESS

  1. Service facilities were categorized into “Owned,” “Aligned,” and “Competitive” entities as it related to site of service.
  2. All health system employed primary care providers (500+) were included.
  3. A patient cohort was created based on established office visits with any of the health system employed primary care providers.
  4. All claims associated with those patients were analyzed over a 2-year timeframe and rolled up by service lines and reviewed by individual rendering providers.

WHAT HSG FOUND

For a region of interest, almost all inpatient stays (86%) were at system facilities, with 57% at the region’s community hospital and 29% at the system’s quaternary hospital in the neighboring region. Most specialist office visits were with employed (35%) or aligned (52%) specialty groups. There was minimal overall leakage (8%) to groups employed or aligned with competitive systems.

System-wide Patient Share of Care was 55% to system-owned facilities with an additional 5% to system-aligned facilities. This indicates that 40% of total healthcare revenue from these patients is being captured by competitive facilities and systems. Patient Share of Care was extremely variable by service line resulting in identified need for additional focus and reassessment of organizational orthopedic service line strategy.

For more information, please call DJ Sullivan.

D.J. Sullivan

Chief Strategy Officer and Managing Director of Claims Data Analytics