Are volume declines unique to my organization?
The first question to investigate when identifying the root cause of a volume decline is whether the decline is unique to your facility or reflective of a broader market trend. If volumes are falling at similar rates at your facility and across the market as a whole, the decline at your facility may be explained by local market trends rather than factors unique to your organization. However, if your facility is seeing a greater rate of volume decline than the market, then the root cause is specific to your organization and requires further investigation.
If so, is the volume decline a result of internal factors?
Once you've determined that your volume decline is unique to your facility, or at least more pronounced than in the market at large, you need to determine if the cause is because of internal factors, such as capacity or practice patterns. As internal causes behind any volume decline are both the most directly actionable as well as the easiest to measure, they serve as an ideal starting point for analysis.
First, evaluate whether your current providers are at capacity and therefore unable to capitalize on the current volume opportunity. Analyzing patient wait times and comparing provider panel sizes to program and third-party benchmarks are effective ways to assess whether your program has a capacity problem.
Further, consider any changes in practice patterns that may reduce the amount of care needed by patients. For instance, one organization we worked with found the main cause of their declining radiation volumes was a change in care delivery, with patients receiving about half as many individual treatment rounds as in years prior.
Could external factors explain the decline?
We recommend analyzing external causes behind a volume decline only after completing an internal analysis because assessing external factors requires a greater understanding of the market and competitors, and because it's more difficult to inflect change externally than it is internally.
To determine if external factors, such as increased patient outmigration, is driving your volume decline, your organization should first analyze the referral patterns of providers in the market, patient preferences, and how competitors compare to your facility on these preferences. When analyzing referral patterns, see what percentage of referrals from physicians in the market are going to you versus to competitor organizations, and how those patterns have trended overtime to identify commonalities and potential explanations.
Patient preferences are also worth investigating. For example, one organization we worked with sought to identify why their obstetrics volumes had fallen in the last year. At first glance, the overall decline in births taking place in their service area seemed to explain their volume decline. However, after investigating further, the organization determined that women were increasingly traveling out of the area to give birth, as the rising desire for alternative birthing techniques was not currently being met. Therefore, it is crucial that organizations analyze both patient preferences in their market as well as how they and competitors meet those preferences.
Is the answer: All of the above?
Sometimes, your volume declines may result from multiple factors, such as a falling population and a mix of internal and external challenges. Therefore, organizations may need to investigate as many potential explanations for their volume decline as possible, thoroughly confirming or ruling out each individual possibility to most accurately determine the cause behind their challenges.