Driving market expansion by influencing patient referrals and leakage

The challenge

Gain visibility into patient referrals and network leakage within a territory

A nonprofit pediatric healthcare system has a range of inpatient and outpatient care sites and offers home health, pharmacy, and telemedicine services. The network was focused on expanding their footprint in a specific state, and to achieve this, they needed to have a better understanding of this territory’s addressable market. Specifically, they needed to better understand the patient journey, referral patterns, and leakage to develop a strategy on how to reach and retain more patients.

The solution

Track patient journey, referrals, and network leakage

The business development team partnered with Definitive Healthcare to map the patient journey for a specific patient cohort using Atlas All-Payor Claims data. For all patients who received care in their network, the team tracked all care touchpoints these patients encountered with institutions and physicians 60 days before and after that point of service. This included identifying hospitals and physicians who saw these patients as well as readmissions and complications.

The impact

Identified 650 sites of care that informed their expansion strategy

This in-depth analysis of the patient journey gave the team vital information to inform their strategy to influence referral patterns, reduce out-of-network leakage, and ultimately grow their market share. For example, the team identified 650 hospitals that patients in this cohort visited within 60 days of receiving care at their facility, and this was a critical piece to identify and prevent leakage after performing specific procedures within their network.