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. Included in this blog is a section of are our Data-Driven Physician Outreach Tool Kit. The piece goes over the 3 primary data sources for gathering insights and the questions you should ask when reviewing for growth planning.

3 Primary Data Sources to Review for Growth Planning

1. 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 any available inbound referral information. Ask yourself:

  • In reviewing inbound referral data, which practices &/or providers are the highest sources of referrals today?
  • Are there consistent patterns when studying  the 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 an under tapped 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?

Next, 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.

2. 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:

While studying internal data can be helpful in understanding referral patterns within your organization, using external data to explore shared patient trends can help liaisons know which providers to prioritize based on the potential growth opportunity. 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 provider’s network integrity rating (strong, reliable, variable or weak) in the External Data Trends column.

3. 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:

One of the most important pieces of data liaisons have access to is field intelligence. Based on the provider conversations you’ve shared in the past:

  • 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?

Download the rest of our Data-Driven Tool Kit

Interested in learning more about Healthcare Analytics?

Date: September 22 2021
Subject: Healthcare Analytics
About the Author
Josh Cameron, MBA — VP, Client Success
Josh Cameron, MBA

VP, Client Success

Marketware