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NETWORK DEVELOPMENT What Does the Data Mean? An Executive's Guide to Crimson Market Advantage Dustin Schwambach Director

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Page 1: NETWORK DEVELOPMENT What Does the Data … DEVELOPMENT What Does the Data Mean? An Executive's Guide to Crimson Market Advantage ... CMA’s data is modeled and

NETWORK DEVELOPMENT

What Does the Data Mean?

An Executive's Guide to

Crimson Market Advantage

Dustin Schwambach

Director

Page 2: NETWORK DEVELOPMENT What Does the Data … DEVELOPMENT What Does the Data Mean? An Executive's Guide to Crimson Market Advantage ... CMA’s data is modeled and

©2015 The Advisory Board Company • advisory.com

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Your Scarcest Resource

Time is the scarcest resource in

most organizations, especially for

senior executives who spend, on

average, more than two full days

a week in meetings.

Knowing what data is quickly

available through CMA and how

to use it, will improve productivity

for you and your team.

Mankins, Michael C., Chris Brahm, and Gregory Caimi. "Your Scarcest Resource." Harvard Business

Review (2014): Harvard Business Publishing Web. <https://hbr.org/2014/05/your-scarcest-resource>.

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Source: Crimson Market Advantage.

Executives Using CMA See More ROI

$3.3M

Average for members without

ROI is 5 logins

Executives log-in 14 times

per month on average

Utilization Trends for Members Achieving ROI in the Last Twelve Months

Average ROI per

member in 2015

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Source: Crimson Market Advantage.

What Does Executive Engagement Look Like?

Leveraging On-Demand Information to Support Your Most Pressing Strategic Questions

Referral

Growth

Physician

Recruitment

Outreach

Management

New Service

Offerings

Footprint

Growth

Market

Shifts

Acquisition

and Affiliation

ACO

Formation

Network

Integrity

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Road Map

©2015 The Advisory Board Company • advisory.com

Evaluate Market Shifts

Monitor Network Integrity

Track Growth from Outreach Efforts

Operationalize Data and Take Action

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Source: Crimson Market Advantage.

Coming Soon: Market Snapshots

Introducing Snapshots in Market Reports

0%

100%

Measure Alignment Changes

Are physicians in my primary market

more aligned after a year of targeted

physician marketing?

75% PCP Revenue Share

July 2015 – June 2016

45% PCP Revenue Share

July 2014 – June 2015

Compare Competitive Position

How is the landscape changing for

outpatient cardiac? We’ve seen an increase,

but is there still opportunity to grow?

Revenue for OP

Cardiac Services

Performed

July 2014 – June 2015

$12M

Revenue for OP

Cardiac Services

Performed

July 2015 – June 2016

$13.5M 12.5% Increase

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Source: Crimson Market Advantage.

New Reports to Monitor Changes Over Time

Utilizing Snapshot Analysis

What is the Snapshots CMA Report?

Your Crimson Market Reports application will have saved templates that will store all new data sets

with each monthly data update. Each data set includes 12-months of data.

• Compare total market

revenue for service lines

across time periods to identify

significant change and new

opportunity

• View market activity for

attending physicians or the

downstream business from

PCPs

• Start with the first available

period, July 2014 – June 2015

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Gleaning Insights from Market Snapshots

Source: Crimson Market Advantage.

Translating Intel to Priorities

Two Things to Know about

CMA Data Updates

• CMA’s market leakage and

network data is refreshed

monthly

• Not all data sources update

each month, so changes

may be small from month to

month, or you may see a

larger jump the next month

Analyze over several months

A change between just two

consecutive periods may be a result

of updates to underlying data

Focus on the significant

growth or decline

CMA’s data is modeled and

provides guidance for where there

is the most opportunity

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Road Map

©2015 The Advisory Board Company • advisory.com

Evaluate Market Shifts

Monitor Network Integrity

Track Growth from Outreach Efforts

Operationalize Data and Take Action

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Source: Crimson Market Advantage.

Managing Your Network to Its Full Potential

Key Questions to Analyze Network Integrity

Are there geographic

patterns of leakage?

Which competitor facilities

are capturing patients from

employed physicians?

What is the value of business

leaking from our network? 59% of CMA Initiatives

involve employed or

network providers

Which service lines have the

most opportunity for keepage?

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Source: Crimson Market Advantage.

Answers Already in Your CMA Application

Identify Employed Leakage and Retain Referrals with the Employed PCP Roster Report1

• View employed PCPs with their downstream revenue to both your organization and competitors

• Use this report to learn about PCPs splitting between you and your competitors and how much that

downstream business is worth

PCP alignment

> 70%

PCP Alignment

30 – 70%

PCP Alignment

< 30%

Understanding PCP Alignment

1) Employed PCP Roster Report is a standard CMA report in the Planner Playbook folder

of your Market Reports Application

Key Metrics

• PCP Leakage: estimate of

referral opportunity from

PCPs in selected service

areas

• Member Revenue:

estimate of downstream

business coming to your

organization

• Revenue Share: estimate

of the referral share your

system is capturing

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Source: Crimson Market Advantage.

Driving Data to Action

Three Member-Proven Strategies to Strengthen Network Integrity

$1.2M Adjusted new revenue

after 24 months

Identify the Root Cause

of Leakage

Geographic Patterns

Patterns of leakage pinpointed

one clinic with significantly less

alignment

Improving Market Presence

• Hospital and physician group

leadership held a week-long

workshop to identify the root

cause of the leakage

• Established direct scheduling

to improve access issues

$1.1M Increase referral

revenue after 5 months

Build Physician-to-

Physician Relationships

Identifying Relationship Issues

Analysis of data at service line level

indicated procedural splitting with

lower alignment in key services

Creating Name Recognition

• Operations team shared data

with employed physician

leaders, leading to discovery

that PCPs do not know about

network specialists

• Project team put together list of

non-competitor specialists for

PCPs to use as a reference

$9.5M Adjusted new revenue

after 12 months

Conduct Targeted

Conversations

Splitting Behaviors

Leakage details on employed

PCPs showed splitting behavior

across the board

Execution Using Scorecards

• Team put together 1-page

documents on each PCP to

facilitate targeted

conversations

• Conversations unearthed

behavioral and operational

issues that had previously

been obscured

Data

Insight

Member

Action

Impact

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Road Map

©2015 The Advisory Board Company • advisory.com

Evaluate Market Shifts

Monitor Network Integrity

Track Growth from Outreach Efforts

Operationalize Data and Take Action

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Source: Crimson Market Advantage.

Emphasizing Accountability to Keep Goals on Track

Initiatives: Setting Growth Goals and Tracking Progress

2014

December 203 – August 2014

With which physicians

are we trying to build

relationships?

Find Your Answers

in Initiatives

What type of business

are they sending to

your system?

How does the business

from these physicians

compare to last year?

1

2

3

2014

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Source: Crimson Market Advantage.

Understanding the ANR Methodology

Key Benefits of Using ANR

Quantifies value of outreach in

terms of revenue in services

(not patient volumes) to

properly weight revenue more

significant to your bottom line

Captures

Financial Impact

Using the Growth Adjustor

separates impact of outreach from

unrelated drivers of growth, such as

aging population, natural market

growth, nearby facility closure, etc.

Isolates Impact

From Market Factors

Accounts for seasonality of

patient visits and other types

of fluctuations to avoid

comparing peak against off-

peak months

Compares Like

Points in Time

New revenue generated by a physician when comparing one

month with the same month in the previous year, adjusted using

a growth projection to account for anticipated market changes

Adjusted New

Revenue (ANR)

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Source: Crimson Market Advantage.

Before You Look at ANR

Analyses of leakage,

alignment and physician

connections help

outreach teams narrow

call lists to an actionable

list based on your growth

priorities

Conversations with

physicians or making

operational changes to

address leakage are

essential to see

behavioral shift and

new business

Use the growth

projection feature to take

into account expected

changes in the market

Identify Physicians Engage Physicians Set Growth Projection

Key Elements for a Successful Initiative

Case in Brief: Northcross Hospital1

• 6-hospital system in the Northeast

• At the formation of each initiative, team agrees on growth projection based on recent service line

performance

• The 2014 advanced imaging initiative included a 10% growth projection and the outreach team was able

to increase revenue from that expectation, resulting in $4M above and beyond expected growth

1) Pseudonym

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2

3

4

1

Road Map

©2015 The Advisory Board Company • advisory.com

Evaluate Market Shifts

Monitor Network Integrity

Track Growth from Outreach Efforts

Operationalize Data and Take Action

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Source: Crimson Market Advantage.

Information You Need at Your Fingertips

Identifying the Big Picture and Diving into the Details

1 Establish expectations for reviewing market data

in planning meetings and to support ad hoc

projects and decisions

Analyze patterns and trends

2 Review data prior to executive interaction with

physicians to understand contribution, alignment,

and opportunity to grow the relationship

Review physician-level detail

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Source: Crimson Market Advantage.

Executives Leverage Custom Reports

Use pre-built reports and

easy templates to create

reports with key metrics

1

Subscribe to reports to

receive a log-in link via

email on a regular basis

3 2

View shared reports built by

your super users around key

priorities and initiatives

Evaluate Market Activity Using Crimson Market Reports

Building or Requesting a Report? Consider How You Want to View the Data.

Employed Status

Include employed and non-employed

physicians to compare alignment and

identify new opportunity

Service Lines

Analyze performance and opportunity

for just key services, or include all to

identify gaps and set priorities

Service Area

Narrow the report by physician location to

focus on specific growth areas

Metrics

• Understand market opportunity and

alignment by using leakage and revenue

share for either attending physician or PCPs

• Understand physician relationships with the

count of shared patients

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Source: Crimson Market Advantage.

Subscribe to Receive Regular Information

Ruby Valley Hospital System Urban campus of 4-hospitals in the West

Ruby’s planning analyst built

out custom reports for each

hospital’s executive team and

subscribed them, so they

receive the updates on the

schedule below

Report Subscriptions

• Member financial trends

• Employed provider leakage

Quarterly

• PCP market share for

targeted providers

• Ad hoc network reports

Monthly

• Service line share by market

• Competitor analysis for full

market

Annually

Sample Suite of Reports for Executives

1. Analyze patterns and trends

Creating a Data-Driven Hospital Executive Team

Executive team wanted to drive strategic data utilization by

developing a consistent set of CMA reports at the corporate

level and for each facility to monitor hospital performance

and arm leadership with data for strategic decision making

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Source: Crimson Market Advantage.

Access Transparency into Physician Market Activity

Login and Search to Access CMA’s Physician Profile

View your share of physician alignment

and the value of the leakage to your

competitors and affiliates

Identify the competitor capturing the

most business from the physician

Drill into revenue and share

details by sub-service line

Physician Activity Metrics

$ Leaked Revenue

Expected reimbursement of

business done at competitor

facility if it were captured in

Member facility

# Market View

Attending is business that the

physician performed and PCP is

business attributed to a referring

provider bases on shared patients

% Member Revenue Share

The percent of attending

revenue performed at the

Member facility

2. Review physician-level detail

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Source: Crimson Market Advantage.

A Strategic Approach to Physician-Led Growth

Protect and Capitalize

Existing Business

LOYAL PHYSICIAN

Maintain the relationship

and ensure the

physicians are happy

with current services

Over 70% member

revenue share

Convert Splitting

Physicians

PRODUCT SPLITTER

Focus on improving the

relationship, understand

reasons for leakage, and

educate on service offerings

Splits on a particular sub-

service line or refers sub-set

of patients to competitor

Create New

Referral Base

COMPETITOR ALIGNED

Work to establish and grow

a new relationship to

understand the physician’s

needs and explain your

organization’s offerings

Less than 30% member

revenue share

Determining the Conversation Based on Data-Driven Referral Characteristics

Relationship

Status

Strategic

Approach

2. Review physician-level detail

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Source: Crimson Market Advantage.

Plan Your Next Step Now

Your ROI Challenge: $500M

Getting There with Executive Engagement

Take advantage of convenient

physician profiles to prepare

for conversations

Check-in with your team on

current projects and Integrate

CMA data into current priorities

Monitor progress of initiatives

and trends in the market

Work with your team and advisor

to subscribe to reports you need