Physician alignment is critical for increasing volumes and referrals, improving patient experiences and boosting revenue. Insights from claims data, when paired with a Physician Relationship Management (PRM) system, can help health systems better understand physician behavior and referral patterns. A data-driven physician alignment approach uses these insights to improve communication between physicians and outreach teams, ultimately resulting in improved physician engagement.
Unfortunately, there are many challenges in reaching successful physician alignment. Health systems are faced with less than ideal sources of market data, inaccurate or incomplete data, and difficulty identifying splitting and/or referring physicians. Armed with the right tools, capabilities, and human capital, hospitals may be able to recapture revenue losses or drive growth.
Tips for Effective Data-Drive Physician Alignment:
- It’s better to be partially, directionally informed by data than not. Health systems should invest time in understanding both internal and external data and their gaps. Enlisting a “physician champion” can help to overcome reluctance about interpreting and using incomplete data. Even though billings systems can be fragmented and dated, and claims data can be inconsistent, the key is to consider directional data in combination with local market intelligence with a PRM system.
- Don’t try to fix everything at once. There’s natural complexity in bringing data and analytics together to effectively drive physician alignment. Start small with one service line and then build upon successes. In order to show ROI of physician alignment efforts, a team may be required to combine internal data, directional data used to inform strategy, and PRM solution data that attributes outreach activity to specific physicians. The actual process health systems use to do so will be highly individualistic, but necessary to scale physician alignment strategies.
- Keep in mind that physician NPI1 identifiers are the lynchpin to bringing different data sets together. This data point identifies physicians and helps health systems maintain consistent attribution when multiple source systems are involved. Master data management can also be used to pull claims data from different sources together for the right use case.
- Leverage solution capabilities, but don’t rely solely on them. Though software and solutions can give the health system insights and capabilities, it’s not the end all, be all. Along with the technology necessary to collect and analyze data, health systems need the right capabilities and human capital to reach out to physicians and provide a good patient experience. Successfully aligning physicians requires much more than just a software solution.
The first step to improving physician alignment is gaining as deep as possible understanding of physicians and their behavior. Even though this data may be directional and incomplete, and the data collection process may be nuanced, the insights are still valuable for organizations who are working to engage the health system’s physicians. Armed with data, organizations can engage in meaningful dialogue with physicians, resolve issues, and build relationships.
Ideally, these relationships can result in fewer patients being seen at out-of-network sites of service, fewer referrals to out-of-network physicians and sites of service, and improved patient and physician experiences overall.