Measuring the Health of the Patient Relationship

// By Wendy Stark Healy //

How much of a patient’s health care spending goes to your organization? And how much goes to your competitors? “Share of Care” is a revenue-based measurement that compiles multiple data points to give you the full picture.

Measuring brand loyalty is a constant challenge for health care organizations. Marketing professionals use different measures to determine if they’re capturing patients throughout their health care journey.

D.J. Sullivan, director, HSG Advisors

One of the parameters being used today is called Share of Care. Share of Care is a revenue-based measurement that gauges the health of the patient relationship, according to D.J. Sullivan, director at HSG Advisors, a national health care consulting firm based in Kentucky. Share of Care should be a health care system’s primary mode of measurement, Sullivan says.

Sullivan and his colleague Eric Andreoli, director at HSG Advisors, presented a webinar titled “Patient Share of Care: Measuring Patient Brand Loyalty” for the Society for Health Care Strategy & Market Development (SHSMD) on August 25.

Marketing leaders, they say, should understand how patients use their health care dollars, and seek detailed information on how services are used based on geography, service lines, and provider types.

Understanding How Dollars Are Spent

Eric Andreoli, director, HSG Advisors

The two compared Share of Care to a concept used in business called Share of Wallet, the measurement system used by the consumer goods industry to gauge profitability and brand loyalty. Share of wallet is the amount of money an existing customer spends regularly on a particular brand rather than buying from a competitor. If used in health care, Share of Wallet would mean the amount of care and services a patient gets at your organization instead of at a competitor’s.

In the case of a knee replacement, for example, a patient would have testing, imaging, follow-up visits with specialists and primary care providers (PCPs), and physical therapy before and after surgery. Share of Wallet would measure how many of these services — and how many dollars were spent — at your organization.

“Both market share and wallet share focus on growing revenue from customers,” they say. “However, growing market share focuses on attracting new clients from the competition. Share of Wallet focuses on growing revenue from existing clients by expanding the number of products being used, which might also be taken away from the competition.”

Sullivan and Andreoli acknowledge that health care is different and can’t be compared to consumer goods, but they offer the Share of Wallet concept to give health care marketers a new way to think about metrics.

Using Metrics in Strategic Planning

The presenters also encouraged marketers to consider how data is used in strategic planning. Both Sullivan and Andreoli are strong proponents of the power of data to measure any patient metric. “Our main belief is that strategic planning is a data-driven exercise,” says Andreoli. “It’s tough to have all the data you want. Do you feel your organization has access to the data to succeed in marketing?”

Strategic planning, they say, requires multiple data inputs:

• Employed practice key performance indicators
• Provider productivity
• Provider supply-and-demand analysis
• Market demographics
• Access point and drive-time analysis
• Patient attraction and retention
• Quality and outcome measures

They recognize that health care data isn’t always robust, available, or even correct, making the challenge more difficult for health care marketers today. Data, they say, can be gleaned from inpatient market share analysis, electronic medical records, and claims information.

Finding Better Data

The two discussed how to find better data for patient behavior and how measuring patient attraction and retention provides foundational information for strategic, service line, and manpower planning.

“A lot of organizations rely on data from the electronic medical record,” they say, “but it only pertains to that specific facility and misses some information. Using this source can provide information on where a patient had services, or which ones they had, but data will likely be missing.”

Using claims data can also help fill the gap, they say, but this, too, has its shortfalls. “Claims data doesn’t represent 100 percent of what’s going on,” says Andreoli. “But claims data does provide a nice portrait.”

Sharing Best Practices

Sullivan and Andreoli shared their best practices for measuring patient Share of Care, and the processes they use to help clients. They help clients identify opportunities to reduce patient leakage — patients who are accessing care at places outside your system.

Step 1 – Identifying Patient Population

• Employed primary care patients
• Urgent care patients
• Emergency Department patients
• Patients with specific procedures or diagnoses

Step 2 – Identifying Target Facilities

• What facilities are considered part of your organization?
• What facilities are you closely aligned with?

Step 3 – Measuring Patient Share of Care

• How much has a patient spent at a target facility compared to the total spent on health care services?

Measuring Primary Care Services

Questions to consider include:

• What are your organization’s biggest opportunities to reduce patient leakage?
• Where do patients have difficulty accessing specific services?
• What is your share, and how does it differ for patients who interact with your primary care, urgent care, or Emergency Department locations?
• What is your share for all patients using your services in a certain area?

The experts say that using primary care provider data is a good way to start measuring but shouldn’t be the only way. Patients getting care at an organization’s primary care locations are usually good indicators of who will use services throughout the system.

“Understand that patient and provider factors drive patient retention,” says Andreoli, “but don’t only focus on provider factors and assume that applying pressure on PCPs will be the best way to improve patient retention.”

They also advise engaging leadership and communicating about the importance of metrics. “Executive leadership should have patient share of care as a key performance indicator on their monthly or quarterly dashboards,” says Sullivan. Patient experience and financial teams may also collect key data.

Key Takeaways

• Organizations seeking to drive growth need to measure both patient attraction and retention efforts.
• Using claims data to analyze Patient Share of Care provides a holistic portrait of care delivery and revenue growth opportunities.
• Driving overall patient dollar capture starts with the PCP. If a health system isn’t successful in retaining these patients, it won’t likely succeed overall.
• Share of Care can measure brand loyalty and identify variation in care patterns.

Wendy Stark Healy is a Connecticut-based health care writer and editor, and author of Life Is Too Short: Stories of Transformation and Renewal After 9/11.