Q&A: Mercy Health on Performance Measurement and Change Management

Like many hospitals and healthcare providers, Mercy Health System wanted to accelerate market share growth, improve network utilization, expand business-to-business sales opportunities, and better track pipeline. They knew they had to rethink their approach to business development in order to make a change.

Mercy began a journey toward success by defining a roadmap of goals, expanding the traditional role of the liaison, incentivizing cultural change, and adopting data-driven reporting technology to target growth.

Recently, leaders from Mercy Health shared their stories with us. Carlos Saenz, VP of Business Development, and Chandra Mowli, Director of PRM and Business Intelligence, discussed the process of aligning technology with data to track meaningful interactions and measure performance.

If you missed it, you can watch the presentation here.

We received an impressive number of audience questions during and after the live presentation. Carlos, Chandra, and Emilio didn’t have time to cover them live, so we rounded them up to provide answers in full. Here’s what they had to say:

Question: What are the BD incentives Mercy has embraced?

10 - 111(Carlos) Answer: We have created multiple verticals and structured an incentive plan for our team members that encompasses each one of those verticals. The opportunity for a CSM to earn compensation for demonstrating good results is up to an additional 10% of their base salary per year. We pay on a quarterly basis to demonstrate routine appreciation. The first quarter was exclusively based on activity and touchpoints, but we tweaked the system in the second quarter to measure the types of focus they had on specific focus lines. We also wanted to incentivize them to enter these touchpoints on a timely basis. As we moved forward, we started incorporating performance metrics  in some of the more B2B functions, for example, the number of contracts that were sold or relationships developed with preferred providers were incorporated as part of that incentive. There are a lot of different components across the verticals that we can incent, and every quarter we tweak it a little more to make it tighter and identify areas of improvement. The team has been very supportive and helpful during this process.

Question: How much time do your liaisons spend with the data?

(Carlos) Answer: We want to move away from purely building relationships to building relationships with intent, so we’ve taken off on a journey to ensure that we are strategic about the providers and service lines that we focus on. You can’t be all things to all people if you are diluting your efforts, you won’t be successful or be able to measure and manage the results that you have. Our liaison team is expected to use the solver data so that, when looking at a service line, community, or group of physicians, they clearly understand the referral pattern and can focus on the providers that will give them the most bang for their buck. We ask them to do this on a Monday or Friday because we want them in the field as much as possible Tuesday through Thursday. We want them focused on becoming strategic CSMs dedicated to building relationships with an intent to grow the business. 

10 - 112

(Chandra) Answer: Let me add a couple of points to orient our goals— if you look at the capacity of a physician liaison defined in terms of whatever benchmarks you use, it’s roughly about 120 touchpoints. How we use that intentionally is very important. We do a lot of work to make sure that our targets are right and are building the appropriate results. To answer the question, our goal is that liaisons spend about 80% of their time in the field and 20% of their time on data activity. That’s where my team comes in — we support them through this analysis and provide them regular reports, in terms of priorities, and make them select the appropriate targeted provider so that they continue the journey of building those relationships to drive sales.

Question: Who develops and creates educational material for your CSN’s to take in the field? Do you use print or digital material as tools in the field?

(Carlos) Answer: We work closely with our marketing team. For example, we are currently on an initiative to grow 90-day prescriptions with our pharmacy and we work closely with our marketing team to create the collateral that we’ll use to develop this. As we expand our support of imaging, all of the collateral to define direct cards and the material that we need to communicate those locations to providers is done in tandem with our marketing department. It’s part of my responsibility and the business development leader’s responsibility to work closely with those operational leaders and then in turn with the members of our marketing team at a local level to make sure that we have uniform templates to distribute that type of content. 

Question: How does provider (specialist) quality influence network referral utilization?

(Chandra) Answer: We are not tracking quality metrics at this point in time with the PRM system. But when you go and ask a provider for a referral, if the quality of the referred-to physician is suspect then there will definitely be resistance in terms of referring to that provider. However, again, that is not something we are tracking within the PRM system.

10 - 113

(Emilio) Answer: If I can add to that, there are certain lanes of expertise that solution vendors tend to stay in. Evariant has focused on segmenting the massive quantity of claims data we receive, from a volume standpoint, and calculating referral activity as it relates to those providers. But we have not dived into being a quality-metric vendor. One of the powerful things about the Salesforce.com technology, the underpinning platform behind the Evariant solutions, is that it is very adaptable and, as a result, if organizations have quality information we are able to integrate that type of information. 

Question: How much time is required to build a dashboard and how easy (or difficult) is it to modify once implemented?

(Emilio) Answer: The native PRM platform from Evariant has the ability to quickly build activity-related dashboards for the outreach that’s going on. However, the dashboards that Chandra presented represents the combination of extracts of data from the PRM system with critical data from Mercy’s other source system. Chandra talked about the sources of truth, and right now those dashboards are built by Mercy within Mercy with Chandra and members of his team. As you saw on the roadmap, there is a mutual goal of trying to automate and build unified reports that would be self-populating for the entire organization to review. This is another example of the journey and of both organizations challenging themselves because it’s not easy to just flip a switch and have perfect reports generated. 

Question: Did your CRM and PRM journey happen at the same time, or did you focus on one before the other?

(Chandra) Answer: That’s a great question. To make it short, the CRM and PRM journey happened in parallel. We practiced the combined discipline of taking a consolidated look at the data that feeds into the PRM and that was going to be common for the CRM, also, which was very good. However, the CRM journey probably finished slightly earlier than the PRM journey the PRM took a little bit longer until we integrated the solver and the intelligence modules too.

Question: Has Evariant worked with clients that have CRM and PRM hosted by different vendors? How does that work in terms of both platforms speaking to each other?

(Emilio) Answer:  We have, but have found over time health systems see value in an enterprise solution where marketing and provider business development can work together rather than as silos and where both strategy and execution are managed from a common set of insights. This means integrated marketing and business development. Being able to leverage the Evariant Patients for Life platform, you get the benefit of seeing the whole market dynamic  including consumer, patient and provider insights. When the data lives in multiple places, you are stuck spending months trying to make sense of it instead of just days or even hours. An integrated solution is the best answer so your team doesn’t need to manage as many platforms. For an organizational technology enterprise strategy, we advocate that you want one source of truth as your system of consumer, patient and provider engagement.

Question: Is the referral data that you use for tracking ROI based on actual Mercy internal referral data or Evariant claims data? If internal Mercy data, is it fed into the Evariant platform?

(Emilio) Answer: It is a combination. Certain of the GIG initiative ROI calculations are best served by Mercy’s internal data, others relating primarily to external/unaffiliated providers benefit from Evariant’s calculated referrals. Currently, Mercy’s internal referral data is not fed into the Evariant platform. However, there are plans to eventually do so and Evariant has already done so for other clients.

Question: What other systems do you use to track referrals?  How is your team structured territory, facility? Etc.

(Carlos) Answer: We use Epic Insight data for these metrics. Our team is structured in five verticals and assigned to local communities. Our verticals include: traditional provider engagement liaisons, team focused on our retail urgent care, external outreach, employers and post-acute services. We assign traditional provider engagement team members with geographical territories for primary care and regional scope for assigned specialty duties. We have four regional leaders and all verticals report into them within their assigned regions.

Question: What is your partnership with marketing to get the support tools you need for your team to be in the field?

(Carlos) Answer: We work closely with marketing, in fact, Chandra and his team support BD from BI and analytic standpoint. However, we have several members of our analytics team that we work with on a day-to-day basis. Occasionally, we count on them for services like helping to build a data table or filling in other data sources that we need. Chandra mentioned the importance of being able to standardize dashboards. Well, we’re working closely with our marketing and analytics team there to develop a single source of truth, for example, for continuity of field which is our referral data. When you think about it, we have three different regions and every region has a slightly different epic system. Being able to develop a single source of truth doesn’t turn on overnight with the flip of a switch. So, we had to work very closely with marketing, the analytics team, our IT organization, and other partners within the ministry.

(Chandra) Answer: And to add on that— Mercy is intentionally building a team of people who will look at this high-value project. What we are doing is valid and breaking silos within our organization. Engaging with this team improves our analytic capabilities and further develops this analytic process and methodology. They involve data scientists, B2B statisticians, etc. 

Question: You mentioned managing relationships with Critical Access Hospitals. What are some strategies you deploy to support CAH partners and enforce alignment for patient transfers?

(Carlos) AnswerWe work closely with all our owned and other Critical Access Hospitals. We also work closely with our Rapid Access Team in each community to assure we can handle all tertiary transports to our larger hospitals. We have dedicated external outreach members of our team to maintain contact with these hospitals and we also employ a swing bed strategy so that we return these referred patients post-discharge to continue their care at their local hospitals. We monitor all requests for transfer, accepted patients and returned to referring hospital patients to assure continuity of care and referral loyalty.

Question: What are some of the data challenges you are facing as you’re trying to develop ROI and attribution measures?

(Chandra) Answer: Attribution is a journey and you have to make incremental implementations to learn more and continuously improve. There are a few key takeaways we are realizing as we get into this  the first one is that the volume of data is huge and we need a scalable and responsive database system. Excel and MS Access solutions will not work — and I’m sure that anybody involved in the journey already knows that. The data needs to be acquired, planned, and combined with other elements and loaded into an analytic framework. Then internally, from a process standpointand I’m sure this will resonate with lots of other health systemswe need to create a system-wide strategy to, not only define, but agree on what a referral is and what is considered in-network and out of network. That is something we are doing in a very intentional way. In the long term, we need to engage with a team with the right skill level. I cannot emphasize this point enough. The right skill level not only to build a prescriptive part of the analytic solution but also a prescriptive part using machine learning and other tools.



Evariant provides a leading healthcare CRM solution suite designed to help health systems transform the healthcare experience for their consumers, patients, and physicians. Built on the Salesforce Platform, our solutions foster richer consumer/patient engagement and tighter physician alignment. Powered by cutting-edge data and analytics, Evariant enables health systems to effectively communicate care options that increase revenue and market share, while optimizing network utilization. Many of the top health systems have selected Evariant to thrive in today’s hyper-competitive and rapidly changing environment.