August 15 2019

Solution Brief: Network Referral and Market Share Intelligence

Improve top-line growth and continuity of care delivery

Solution:

Referral Assessment
– Identify drivers of out-of-network referrals at actionable levels (i.e., zip code, specialty, PCP, specialist, and procedure) and quantify impact on revenue lost
– Evaluate sources of volume and downstream utilization to assess how patients flow through care journeys

Market Intelligence
– Measure market share and compare volume flow to competitors by service line
– Determine accretive partnerships to build strong referral channels

Physician Alignment
– Determine and rank the loyalty of employed vs. affiliated physicians to prioritize loyalty improvement efforts
– Identify potential acquisitions of physician groups to support growth efforts and improve referral capture especially for high-value service lines

Why Clarify:

– Clarify is uniquely positioned to solve for referral opportunities given our data coverage as a CMS Qualified QE entity, with 100% of Medicare part A, B, and D data, which we have augmented with 100M commercial lives
– Sophisticated referral logic allows for complete visibility into the patient journey through illumination of multiple strings of downstream referrals (e.g., second or third order referrals)
– Referral insights are delivered at granular levels (e.g., zip code, PCP, specialty, CPT / DRG level) to enable precise targeting of improvement opportunities
– Best-in-class AI-driven surfacing and prioritization of high-impact improvement opportunities
– Dynamic online interface allows for customizable drill-downs into the data through multiple types of visualizations

Impact:

– Improve top-line growth by $100M just through a 10% improvement in in-network referrals
– Improve physician alignment strategies by assessing physician loyalty and identifying potential accretive physician acquisitions and partnerships opportunities
– Understand competitive landscape and identify areas for expansion through complete visibility into competitor market share and referral patterns
– Improve continuity of care by managing patients in network to reduce unnecessary utilization, increase patient satisfaction, and improve clinical outcomes

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