Patient leakage from a health system network is an emerging critical issue facing healthcare leaders. As Medicare and Medicaid reimbursements continue to negatively affect operating margins for even high-performing health systems, competition for privately insured patients is increasing. To compensate for flat or shrinking fee-for-service revenue from the Centers for Medicare and Medicaid Services, many health systems are participating in the agency’s value-based care payment programs; while this presents new revenue opportunities, it also puts pressure on systems to improve outcomes.
Adding to these challenges is competition among health systems as consolidation continues to shrink the number of players in markets. Ensuring your organization remains dominant, or even competitive its market, depends on your ability to attract new patients and retain them in your network. If they do leave, it’s critical to identify the leakage immediately so that steps can be taken to “repatriate” those patients back into your health system.