Review Data Sources for Growth Planning

Review Data Sources for Growth Planning

The leaders of today’s physician outreach teams will attest that data is the cornerstone to the successful development, implementation, and monitoring of referral development initiatives. When it comes to growth planning, 3 primary data sources can provide valuable insights.

3 Primary Data Sources to Review for Growth Planning:

Internal Data

Data Sources

  • System billing
  • Practice EMR
  • Hospital compare

What You Can Learn

  • Historical growth (organization, service line, physician, market)
  • Patient experience & quality trends
  • Potential patient pipelines
  • Identification of “good volumes” (payer mix, case mix, direct costs)
  • Leakage opportunities
  • Referral trends (top partners, 1st referrals & key variances)

Review the Data

Most liaisons start with internal data to review available inbound referral information to understand your current referral patterns. This includes analyzing which providers are sending you the most referrals, which specialties are generating the highest volume, and any trends or changes over time. Ask yourself:

  • In reviewing inbound referral data, which practices &/or providers are the highest sources of referrals today?
  • Are there consistent patterns when studying volumes over time, including not only month-to-month but current vs. the same period in the prior year? Which providers or practices have volumes that can be identified as stable, increasing, or declining?
  • Do we have a report that highlights 1st time referral sources? Consider identifying these providers or practices as new.
  • Which markets represent a strong patient pipeline today?
  • Are there any other key markets of focus based on patient population, payer mix, etc.?
  • Consider reviewing the sources & volumes tied to the key market(s) above. Do any additional referring providers or practices emerge at the top of the target list?
  • Are there any specialties that are under-tapped in the patient pipeline?
  • Consider reviewing the sources & volumes tied to niche specialties. Do any additional referring providers or practices emerge at the top of the target list?

List referral sources in order of volume on the Top 20 Outreach Targets worksheet and mark them (stable, increasing, declining, or new) in the Internal Data Trends column.

External Data

Data Sources

  • US Census
  • State hospital association
  • CMS
  • All-payer claims

What You Can Learn

  • Market demographics
  • Market position
  • Splitter behaviors: facility & physician loyalty
  • Services poised for growth
  • Network connections via shared patients

Review the Data

Studying internal data can be helpful in understanding referral patterns within your organization. However, using external data to explore shared patient trends can help liaisons know which providers to prioritize based on potential growth opportunities. Ask yourself:

  • When reviewing the list of providers identified in our internal data research, what percentage of patients do they share with our employed or in-network providers vs competing providers?
  • Do trends over time suggest these connections are strong (80% or higher), reliable (60-79%), variable (40-59%) or weak (<40%)?
  • Who are the top referring providers in the key market(s) highlighted during our internal data research?
  • When looking at our shared patient volumes, who do they appear to be most connected to?

Now, on the Top 20 Outreach Targets worksheet, add the provider’s network integrity rating (strong, reliable, variable, or weak) in the External Data Trends column.

Field Intelligence

Data Sources

  • Field visits with providers
  • Administrative team
  • Service line leaders
  • Recruiters
  • Practice managers
  • Issues analysis

What You Can Learn

  • Historical interactions between hospital-provider & provider-provider
  • Provider motivations
  • Sample referral mapping
  • Existing referral relationships that would be difficult to navigate
  • Key issues & opportunities

Review the Data

Perhaps the most important piece of data liaisons have access to is field intelligence. Their firsthand insights into physician needs, concerns, and referral decision-making can inform your strategic planning in a way that internal and external data cannot. Based on the provider conversations shared by your outreach team:

  • Are there clear reasons as to why key providers are sending outside of your network today (i.e. alignment, capacity, access, quality, proximity, payors, politics, patient preference, personal)?
  • Are there any strategic initiatives underway that may address some of these reasons?

By combining these three data sources, you can develop a comprehensive understanding of your current referral landscape and make informed decisions to drive future growth.

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Date: July 10 2024
Subject: Healthcare Analytics
About the author
Josh Cameron, MBA — President, Marketware
Josh Cameron, MBA

Executive Vice President

Marketware, a Division of Medsphere