Rick Grape

Posted on: June 25, 2019

Come on, sing it with me. Remember the Disney ride, It’s a Small World? Aside from the catchy tune and robotic dolls, the ride shows that we are really all connected. We are linked, no matter where we live or where we come from. The same can be said for physician referral patterns within your health system.

Sphere of influence, sounds like a business buzz word right? Not the kind of term you’d think of when it comes to accessing the physician referral patterns that illustrate how physicians refer patients within a health system. So how do you get a view into the different spheres of influence within your health system’s service area in order to see the patterns driving referrals for say cardiology? Orthopedics? Or even an individual patient’s care journey?  With the world of mergers and acquisitions, increased competition and the drive to patient consumerism, where do you start?

You have the answers right at your fingertips, but you may not know it. It doesn’t have to be a guessing game.

Connected Insights

Medical claims data can give insights into your provider referral networks and patient care teams down to the most detailed level. Here are just a few examples:

  • Service line defined by ICD and HCPCS codes
  • Patient gender, age, or service location
  • Setting of care (e.g. Inpatient, Outpatient, Ambulatory Surgery Center, Office, etc.)

When you understand the exact role and sphere of influence each physician or specialty plays in how patients move through your health system, you can better make connections in planning, strategy, and recruitment to drive value and cut costs.

Data Driven Decisions

Unlike other sources typically used for data insights, medical claims-based data delves deeper. It uncovers physician connections, recognizes how a physician is splitting time between facilities, and identifies providers who are referring outside of your system and network.

Armed with that knowledge, you can make informed decisions that truly impact financial performance: deciding which high-value physicians to target, gaining insight into what the market looks like, and determining if there is evidence that patients are migrating to competitors. And then the song can get stuck in your head..It’s a Small World After All…

See for yourself, listen to our recent webinar: Pulling a Rabbit Out of a Hat: How Hospital Marketers Can Influence Cost, Care, and Outcomes.

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