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Loyalty after provider attrition: Following providers out of the network

By Nick Stepro, Chief Product and Technology Officer at Arcadia and Krutika Vyas, Senior Technical Implementation Engineer at Arcadia
Healthcare Analytics Medical Cost Containment
Loyalty after provider attrition

We often discuss the ‘who,’ ‘what’ or ‘why’ behind physician attrition — but do patients follow providers when they leave? The artist examined trends in patient loyalty that accompany attrition. Once a patient forms a relationship with a doctor, that provider’s network affiliation may become a less important factor. So, when physicians change affiliations, some patients (and dollars) move with them.

The artist used two years of claims line-level data against provider rosters from a large ACO to show the patient movement trends that accompany provider movement in the first-year post-attrition. The artists measured loyalty for each specialty by looking at the volume of patients revisiting their specialty provider. Orthopedics saw the highest patient continuity after leaving the network, while patients were quickest to ditch their ophthalmologists.

The vertical chart digs deeper into the loyalty score: Arcadia analyzed the patient commitment to the providers in the year before and after their transition out-of-network. The midpoint on the black line indicates the provider switchover — and the colored line indicates the change in patient flow. For each specialty, how many of the same patients stuck with their provider? As the lines slope to the left, more patients leave their now out-of-network specialist. The severity of the trend line’s slope indicates the rate of drop-off. Like orthopedists, urologists also maintained more than half of their patients a full year later, but with greater fluctuation month-to-month. Dermatologists saw more 75% of patients eventually move on by the year’s end — though at a slower rate than ophthalmology patients, 90% of whom were gone within one month.


SQL, D3.js SVG, with Illustrator
Data sourced from Commercial Claims and Provider Roster data from a large ACO