The Growth Channel

What’s better: 4,000 new patients or 1,000 repeat customers?

by Madhavi Kasinadhuni

If you’re putting together a strategic plan for 2015, chances are patient preferences are playing a big part in the discussion (if they’re not, here’s why they should be). Maybe you’re considering opening a retail clinic. Or maybe you’re going to expand your virtual visit program. No matter the strategy, you’ll want to see return on your patient-centered care investment. So how do you measure it?

Traditionally, you’d look at volumes. So let’s say you launch a retail clinic, and in the first year, the clinic sees 4,000 patients. Seems like your strategy is paying off, right? Not necessarily. Volumes don’t tell you whether you’ve attracted new patients, and they don’t tell you anything about patient loyalty or satisfaction. The extra visits could have come from 1,000 repeat customers—or 4,000 one-time patients.

So to see how well you’re meeting your goals, you need a new metric: patient share. And we have a tool that calculates it for your Medicare population.

What is patient share?

Patient share is the strength of your relationships with consumers in the market. It’s made up of two metrics: reach and loyalty.

Reach refers to the number of touch points you have in the market—in other words, how many unique patients you’re interacting with. Loyalty refers to the proportion of a patient’s total care that occurs within your network.

Patient share metrics provide needed insight


In our retail example above, a clinic with 4,000 one-time customers would have better reach, but a clinic with 1,000 repeat customers would have better loyalty.

Measuring patient share is easy enough when you’re working with finite numbers, but it’s a lot harder to do at the aggregate level. We developed the Medicare Total Share Performance Assessment to help you track your Medicare patient share and understand how to calculate it for other populations.

How do you measure reach?

We recommend using population share, which is the percentage of health care consumers receiving any service at your facilities. Unlike procedure volumes, population share spans the care continuum.

Measuring reach


Start at the market level to see how your reach compares to other providers. A small relative population share signals either ineffective service distribution or insufficient service relevance to key demographics. After evaluating population share at the market level, segment it to see which patient groups you’re reaching and which groups you need to focus on.

When you’re segmenting, it’s best to start with cohorts that have population estimates available and are easy to identify in your internal data. Measuring reach for specific target populations like diabetics will require you think critically about the data you have available within your organization as well as estimates available for your service area. If you're using the Total Share Performance Assessment, you'll have the data needed to view Medicare patient share by number of chronic conditions or specific disease states.

How do you measure loyalty?

You can evaluate loyalty by estimating the percentage of a patient’s total health care spending—or “share of wallet”—that goes to your organization. Tracking share of wallet can pinpoint gaps in your service offerings, poor patient engagement, or changes in physician preferences.

Why estimate share of wallet?
There is no magic health care data set that will give you total spending for all the patients you serve. The bank you use for checking services probably makes assumptions about your broader banking needs based on your demographic profile and past spending; and uses that information to approach you about a savings account. Likewise, health care executives will need to make assumptions about patients’ total health care expenditures to improve their consumer appeal.

To estimate an individual’s total spend (the denominator in your share-of-wallet calculation), use cohort comparisons and care pathways to identify appropriate services. And since an individual’s health care spending ebbs and flows over time, examine share of wallet across years, episodes, and encounters.

Measuring loyalty


Once you’ve calculated your reach and share, you can assess the impact of any patient-centered care investment. Until then, you run the risk of overestimating—or underestimating—your success.

Access your Medicare patient share data

Medicare Total Share Performance Assessment

Marketing and Planning Leadership Council members have full access to the Medicare Total Share Performance Assessment. Not a member? Learn more about our expertise and resources.

Use the tool