3 tips to reduce patient leakage and improve patient retention

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By Alex Card

It might start as impatience over wait times in your office lobby or a negative score on a CAHPS survey. Suddenly, longtime patients are missing appointments or canceling procedures.

It’s not always easy to pinpoint when patient leakage evolves from a localized issue into a problematic trend for your system, but you know the signs—and you know dissatisfaction has a way of spreading.

Keeping patients in your health system has obvious short- and long-term benefits for revenue, but it can also ensure those patients have better experiences through more cohesive care coordination.

Whether you’ve just lost a few patients to competing systems or you fear an exodus is imminent, the right data can help you make sense of where and why patients are leaving, and show you how to best communicate your value to keep more in your system.

Why does patient keepage matter?

A survey of 138 hospital and health system leaders found that preventing patient leakage was a top priority for 94% of respondents. Around 65% said that patient retention was a primary obstacle to their financial goals.

This shouldn’t surprise any healthcare professional. Patients are THE reason health systems exist at all. Providers have an ethical and professional responsibility to treat patients, but patients are also critical assets whose average lifetime value to a system is often in the six-figure range—in some cases, more than $600,000.

The surveyed health system executives estimated that patient leakage was responsible for a roughly 17% reduction in revenue in 2021. Some of this loss was necessitated by unavoidable pandemic realities. Facilities without free beds due to surging COVID-19 cases, for instance, had no choice but to transfer patients to their neighbors, whether in-system or not.

But plenty of other causes of leakage existed before the pandemic: Inefficient call centers, inadequate or user-unfriendly web experiences, and simple failure to follow up with patients and coordinate care.

In these cases, patients may feel that a system or provider puts its best foot forward in acquiring their business, only to offer a hollow, inconvenient or inconsistent experience once they’re already through the door.

If your system is putting more time, effort, and money toward acquiring patients than it is on keeping those who are already in, you’ll likely see losses from leakage far beyond whatever your system hopes to save by cutting retention costs.

1. Focus on patient retention rather than leakage

Many providers focus on identifying and engaging with key referral sources to combat leakage, especially in crowded, highly competitive markets. While this tactic is useful, it only addresses the symptom of the problem rather than the problem itself.

You can spend plenty of time and money trying to define and gain visibility into potential areas of leakage (much of which comes down to missed referral opportunities), but it’s often simpler to direct your efforts toward keeping the patients who have already put their trust in your system.

On a granular level, this means encouraging staff to practice great bedside manners, spend more time connecting with patients between visits, and being receptive to patient criticisms or suggestions. Systemically, this might involve surveying all patients for valuable feedback, working to shorten wait times, and ensuring that a person—rather than a voicemail or auto-answering system—is always available to handle calls.

One 2020 survey of senior executives at U.S. hospitals found that the number-one cause of patient leakage was competitors providing easier access to their services. The number-two cause was service line gaps.

In other words, keepage is largely a matter of making it as easy as possible for your patients to continue to access your services—and ensuring that the services they need exist within your system. Of course, the right data and analytics can go a long way to optimizing network utilization. Make sure you partner with a vendor that can meet your organization’s unique requirements.

2. Create access points for your patient demographic

Ease of access will mean different things to different patients. Those on the younger side typically prefer a fully digital experience that fits into their busy, less-structured lifestyles. Their first point of contact with your system might be through social media, where they’ll expect a warm, informative presence—but too friendly, so as to keep the feeling professional.

These patients are often looking for online scheduling, communication with physicians via email or direct messaging, and the ability to see lab results and other follow-up information in their inbox or through an app, such as MyChart. They tend to opt for a telehealth appointment if their situation permits.

Older patients are more likely to have discovered your system through traditional media or after being referred by an affiliated physician. They’ll probably reach out first to your call center, where they’ll expect to make contact with someone who can answer their questions and connect them with the care they need without wasting their time.

Your system will need to cater to both demographics without sacrificing quality in either channel. For new patients, this is your chance to make a great first impression. And for existing patients, this is where you remind them why they chose—and continue to choose—your services.

Still, you’ll need to understand your patients’ needs and preferences at a higher resolution to ensure they have no reason to leave your system. With the right healthcare intelligence, you can better understand how your current patients (and patients like them) access care, which services they require and how the competition’s offerings stack up against your own.

3. Use the right data to get insight into the patient journey

When patients are onboarded into your system, they produce data that tells a story: What their diagnoses are, which drugs or medical devices they’re using, where they live and how they pay for services. If they were referred in from out of network, you’ll know which physician referred them, too.

This story, of course, is really just a snapshot of a moment in a larger patient journey. The more you know about that journey, the more you can address service-line gaps that force otherwise-satisfied patients out of your system.

Claims data can help you track the full patient journey by offering insight into referral and utilization patterns, whether among a specific patient cohort, within a geographic region, or among your competitors’ networks. These data can also help you understand where patients who left your system may have gone, and which services they were seeking.

You can also use claims data to see how your patients’ clinical outcomes compare to those of your competitors, and how competitors’ quality metrics stack up against your own—as well as how those metrics correlate with financial performance.

Online reviews and social media feedback can provide valuable qualitative insights into your patients’ experiences and those of your competitors’. Plus, these offer opportunities to engage with patients directly and highlight your organization’s professionalism by addressing negative reviews with compassion (and, usually, an invitation to handle their concerns offline).

Once you better understand your patients’ journeys, you can make more informed decisions about investing in the facilities, therapies, and staff that they need to stay in your system.

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