Insights for Providers
Apr 10, 2024
Now more than ever before, health systems are focused on driving sustainable growth. New volume growth, patient retention, and service line expansion are key levers of focus. Growing volume and expanding service lines don’t guarantee success, though. Many healthcare providers lack the trusted insights they need to make fast, strategic decisions that will future-proof their system against increasing competition and changing consumer demands. In order to effectively align your growth strategy with your market needs and ensure you’re making the right investments at the right time, you need a data-driven approach. Clarify Health CEO, Jean Drouin, MD, and Paul Deeringer, SVP of Strategy and Emerging Business at John Muir Health, recently hosted a webinar on this topic of “Data-Driven Strategies for Growth”.
In this webinar, Paul spoke to how data-driven decision-making has enabled smarter strategic planning and business development programs at John Muir Health (JMH). A key area of focus for JMH has been to analyze their current provider network structure and its performance while looking for better ways to segment performance insights. They are also re-thinking how they evaluate the relative quality and efficiency of their current in-network providers to determine if they should restructure networks. Paul compared building a network to building a fantasy football team,
“If you think about it like fantasy football, you’ve got your keeper or cut list. When looking at prospective targets, if we know that we’re pretty thin in coverage in this geography, who do we want to actually approach to join our network, and how do we evaluate them?”
– Paul Deeringer, SVP of Strategy and Emerging Business, John Muir Health
Looking at initial performance analyses, JMH found that there was a big opportunity to improve physician alignment. However, because you never have 100% of a provider’s volume, it can be difficult to understand what’s going on outside of your hospital and to know if they are the right provider for your patients. Paul discussed how they are solving for this by coupling their internal view of their network performance with credible outside-in views of what’s actually happening with across quality, efficiency, and downstream referrals.
“For our independent contracted network, which is at least a third of our primary care network, we have fairly limited transparency into what’s going on with the rest of the care that they render. That’s where it becomes really important that in addition to our inside-out view of the network, we couple that with credible outside-in views of what’s happening on quality, efficiency, and referrals.”
When you have don’t have a complete picture of what’s going on with a segment of your providers, it’s difficult to drive real behavioral change across the organization. Prior to working with Clarify, one of the challenges JMH encountered using external analytics resources was particularly in smaller geographic segments. While there are a number of tools in the market that look at referrals broadly, it becomes increasingly difficult as you narrow down the geography you’re looking at, and that’s oftentimes where many organizations actually need support. Paul mentioned this challenge with referral analysis and the roadblocks he’s seen come up for his colleagues with fragmented EHR markets:
“They maybe see 20-30% of what’s happening….even with the benefit of building out fairly robust internal analysis and reporting on referrals, you still end up with holes where either you just don’t have the EHR penetration or it’s just a market you don’t touch as much.”
Paul went on to further discuss the impact John Muir Health found in smaller markets when supplementing their internal referral insights with Clarify’s external expertise. When more broadly thinking about what JMH can build in-house vs. when they turn to external support, Paul shared the following insights:
“I would say that we’re probably 90% reliant on internal data for many applications, but as soon as you step outside of our core geography, our ability to do that drops off significantly.”
With a clear view of what’s going on beyond their health system’s four walls, John Muir’s strategy team has gained an enhanced perspective on overall market trends and network opportunities.
Watch the webinar “Data Driven Strategies for Growth” today to learn more about how Clarify’s partnership with JMH allowed them to explore referral patterns at a microlevel, uncover meaningful insights, and develop the right processes to drive growth and alignment at their organization.
