Valued Voice

The healthcare industry is undergoing a seismic shift. With the rise of consumer-centric giants like Amazon, Johnson & Johnson and CVS Health, health systems are facing unprecedented competition. To thrive in this new landscape, leadership must transition their health systems from a provider-centric to a patient-centric model, and a crucial component of this transformation is understanding and quantifying their Patient Share of Care.

Patient Share of Care, a metric developed by HSG in collaboration with academic and community hospitals, is the percentage of a patient's healthcare spend within a specific health system. This metric can highlight invaluable insights into patient behavior, preferences, and loyalty, all critical areas to be aware of when looking for growth and development opportunities. Traditional metrics like NPS and HCAHPS, while valuable, can fall short of providing a comprehensive view of patient engagement.

The Importance of Quantifying Patient Share of Care

There are several benefits to utilizing a single metric for organizational growth and development:

• Identifying revenue opportunities: Pinpointing where patients seek care outside the health system can reveal untapped revenue streams.
• Optimizing service lines: By understanding which services are most valued by patients, health systems can allocate resources effectively.
• Enhancing patient experience: Identifying leakage points in the patient journey allows for targeted improvements.
• Strengthening market position: A deeper understanding of patient behavior can inform competitive strategies.

Overcoming Challenges

While the benefits of quantifying your health system’s Patient Share of Care are substantial, challenges remain if your data is fragmented or you face continued interoperability issues. Developing a data-driven approach with data analytics and patient journey mapping experts is essential for building a sustainable and patient-centric future.

Patient Share of Care in Action

Our analysis of national claims data revealed significant variation in Patient Share of Care among health systems. One health system that HSG partnered with was able to utilize this metric to identify areas of patient leakage from their network, and as a result, we helped them develop and implement targeted strategies to increase their share of care by 0.5% in one quarter, resulting in a $25 million revenue boost.

Conclusion

Patient Share of Care is a critical metric for health systems navigating the evolving healthcare landscape. By understanding patients and optimizing their journey, organizations can improve financial performance, enhance patient experience, and gain a competitive edge.

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