Improving Revenue, Value-Based Care Using Data

Curtis Gattis, cofounder and chief executive officer, LeadingReach, discusses the importance of the referral to appointment ratio with regard to how tracking this metric can enhance value-based care for patients and significantly increase a provider’s revenue.

Read the full transcript:

Hi, Maria. My name's Curtis Gattis. I'm a cofounder and CEO at LeadingReach. I've been in this role since we founded the company back in 2014. I have a background in technology, really along product and business development and sales management lines.

Most of my responsibility has been bringing products to market, looking for product/market fit, and then scaling organizations once we've had a chance to determine product/market fit and begin the fun job of selling those said solutions.

Can you talk about some of the challenges facing health systems in regard to their referral to appointment ratio? How do these challenges impact revenue?

We believe at LeadingReach that this the most undervalued and undertracked metric in all of health care, the referral to appointment ratio. If you ask other organizations, anywhere from Facebook and Amazon all the way down to even nonprofits that are out there trying to grow, everybody tracks their conversion metrics, that classic close rate, if you will.

This is a metric that has gone largely untracked and unmeasured in health care. It's a real shame, in my humble opinion, simply because at the core of it, it's all about getting patients the care that they need in a more timely manner.

Obviously, if you start to look at this from a fee for service perspective and someone who's receiving referrals, there is a lot to gain around the ability to understand and track where your business is coming from and then, obviously, do things to optimize that business and capture as much patient volume as you can, whether you're a small, independent couple of doc orthopedic shop, as an example, or all the way up to the largest health systems in the world.

How can care teams avoid revenue leakage by communicating more effectively with each other while monitoring and facilitating care transitions?

At the end of the day, it's all about, again, getting back to that referral to appointment ratio number and tracking all sources of referrals that come into the business. For the receivers on the receiving end, whether that's a specialist or even things like PT or rehab, it's really important for them to make sure that they're aware of the full opportunity that's hitting their door.

Again, we see all kinds of different things out there since this our business and what we focus on. I see everything from referrals not getting called at all and the standard default is, "Hey, we just wait for patients to call us," to even referrals getting thrown in the trash at 5:00 because an employee wanted to go home. Anything and everything there in-between.

Therefore, we believe it is absolutely critical for the operators, and the leaders, and even up to and including the doctors, to understand what are their conversion metrics and help to drive those north. First and foremost is better patient care. Those patients were sent wherever they were sent because they were sick, and needed help, and needed care.

Focusing on this, first and foremost, really does value the patient. It obviously helps those who are receiving referrals, again, in a classic fee for service mindset. More referrals means more revenue.

Thinking future states and future business models as we continue this transition of care into value-based, many of the PCPs that we work no longer will fax referrals.

They are looking for folks who are measuring this metric and putting accountability on both sides of that transition of care so that they can ensure that the patients that they have get the care that they need, versus either, again, going into that proverbial black hole or spending an inordinate amount of time chasing these patients after they leave their office, just through physical phone calls and maybe even faxing, again, to try to get updates on their patients once they've left.

Again, for us, we believe it's a critical metric, regardless of what future incentive model wins out. It really is, again, at the core. It's the best for patient, but it also helps those who are tracking revenue and trying to minimize leakage.

Can you talk about what was learned in the recent 9-month ROI case study?

That's what really brought it to life for us. This was a really insightful case study for us. This was a large cardio group, part of a large health system that we started to do some analysis on.

We had to start with a baseline. Fifty percent of paper-based referrals never convert to an appointment. That's data that you can find out there on the Internet. Fifty percent of patients don't even get an appointment when they're being faxed.

What we decided to do is go and start to establish a baseline and then see if we could drive that number up. We established a baseline with this cardio group in January of that year of 64%.

What they ended up doing is taking all referrals, regardless of whether they came digitally through our network, or through the fax machine, or phone call, or anything else, and started to put them into our product, and used it as a classic CRM. Think of patient pipeline management tools similar to a pipeline management tool for any business.

We were able to track that 64% and drive that all the way up to 94%. That clinic grew a million dollars a year in revenue at the clinic level, not including the increased revenue at the hospital because as you have increased appointments, you're going to have more procedures, more imaging studies, etc.

That clinic made over a million dollars a year at the clinic level, not including the downstream revenue, for our basic package of $349 a month. The ROI literally calculated out was over 19,000% for that clinic.

This was a big eye-opener for us. It helped those senders, again, who were wanting to make sure those patients were seen and helped the patients themselves. It was undeniable ROI for that health system to take a look at that data and say, "Hey, this is something that we need to be tracking across all of our clinics because there's a massive revenue growth opportunity right underneath our nose.”

What tips do you have for places looking to improve money practices?

I would get back to that case study that I had just talked about. That was incredibly eye-opening. I'm a big fan of the adage “you can't manage what you can't measure.” I challenge folks all the time to ask themselves, "What is my true referral to appointment ratio?"

Sure, I can go into my EMR and see how many appointments I had last week. That's one thing, but that's not the full picture. Those are just the ones who actually got on the books.

What we do is we challenge people to think about a couple of things. First and foremost, what is my referral to appointment ratio? Secondly, how many referrals am I getting from certain groups? That's the lifeline of my business.

Third, and most importantly, those that didn't get scheduled, why didn't they get scheduled? That represents that growth opportunity right underneath our nose. We see all kinds of things. Maybe I've got bad referral patterns where Maria's sending me patients and I'm an upper extremity orthopod and you're sending me lower extremity cases. We can clean that up with a simple phone call.

Maybe it's an insurance out of network. "Hey, Maria, I'm not taking that insurance today." Many times, it's honestly just staff behavior. Once you start to shine a flashlight on this, you get insights into, "Hey, Maria. It looks like you're doing a good job making your first phone call to these patients within a week, but we're not making our second phone call in three or four weeks later, or sometimes never."

If you give a patient a couple weeks between your first phone call attempt and your second phone call attempt, the chances of that patient coming into the office go almost to zero. The reality is 80, 90+% of the time we're having to leave messages for patients as we're trying to get them scheduled.

Really, the advice that I would give to any specialty clinic, or group, or health system across the country is hone in, and own, and manage this referral to appointment ratio number. It's the most important number that drives your current and future business.

Again, you can't manage what you can't measure. You look at other industries, all across the country, all across the world. Everybody came across various revenue streams. Understand, manage, and track these numbers.

We believe it's critically important for both current and future states of health care for the specialists to hone in and take ownership of this number and ensure that patients are being seen in timely manner, which helps support the value-based initiatives, but again, obviously, supports them in their fee for service environment and, again, the patients themselves.

Is there anything else you would like to add today?

I don't think so. Just appreciate the opportunity and welcome anyone who's interested in learning more to hit our website, leadingreach.com.