Modernizing physician alignment strategies requires understanding physician behavior through data analytics to better modify and track performance, improve referral rates, and align physicians with the healthcare institution's goals in order to impact financial performance and compete in today's changing healthcare landscape. Sophisticated physician relationship management systems provide a 360-degree view of physician loyalty and activity across specialties using integrated healthcare claims data to facilitate meaningful dialogue between physicians and the institution.

1. Modernizing
Physician Alignment
Strategies with
Data Analytics
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3. Evariant | 3
Physician alignment is critical to the success of your healthcare system. If your
institution cannot secure strong alignment, it can have significant repercussions.
In a recent study sponsored by Accenture, it discovered that U.S. hospitals that
deliver superior patient experience generate 50 percent1
higher margins than
average providers. According to another Accenture study, “seven percent of
patients switched providers due to a poor patient experience. This switching
translates to a loss of $100M in annual revenue per hospital.2
” Indeed, a
successful approach to physician alignment can impact your institution’s
financial performance in many ways.
To achieve both physician alignment and optimize patient care in today’s
hyper-competitive environment, you must have a view into physician activity
and referrals. Understanding physician behavior provides the basis for more
meaningful dialogue with the physician so as to better modify and track future
behavior and align physicians with your institution.
Introduction
Tweet this:
Knowledge of physician activity + referrals is
necessary to see successful #physicianalignment

4. Evariant | 4
However, as fast as the healthcare landscape is changing, so too are the
methods and technologies you need to ensure successful physician alignment.
We now realize it “takes a village” to keep your physicians happy, and that
means just making phone calls and visiting physicians to promote your services
is not enough.
This eBook describes how to achieve better physician alignment through the
use of data analytics to:
Physician
Alignment
Value Cycle
Physician
Alignment
More
Revenue
More
Referrals
Improved
Physician
Experience
Improved
Patient
Experience
Identify baseline issues that
negatively impact physician and
patient satisfaction
Help your institution achieve its
revenue goals
Utilize relevant data-driven
intelligence to conduct meaningful
dialogue with physicians
Improve referral rates

5. The Changing
Healthcare Landscape
Makes Physician
Alignment a MUST

6. Evariant | 6
As the healthcare industry continues to evolve, it is critical that your
executives, physicians, and administrative personnel stay informed
about industry trends so you can continuously adjust your organization’s
strategy to anticipate and meet market needs. The changing nature of
your competition, the quest to improve the patient experience, and the
on-going journey to optimize conventional and new, innovative patient
channels are just a few examples of recent dynamic trends. Addressing
these trends and tackling other business challenges are compelling
healthcare organizations like yours to revamp existing strategies and
implement modern technologies with the objective to garner more data
and make more informed decisions to enfranchise both physicians and
patients.
According to Gartner, healthcare providers will spend approximately
$108 billion on healthcare IT in 2016, with expenditures continuing
to grow for the next five years3
. For most healthcare organizations,
implementing and maintaining Electronic Health Records (EHR)
and staying current on regulatory requirements have dominated IT
spending in recent years. While we all hoped that the EHR could provide
comprehensive data analytics capabilities, it doesn’t provide your
organization with the necessary data to enable and facilitate physician
alignment analysis and management to increase referrals and revenues.

7. Evariant | 7
Tweet this:
Your org must have a #physicianalignment
program in order to keep up with competition
In 2016, Merritt Hawkins forecasts that a primary care physician will
generate upwards of $1.4 million in revenue and some specialists will
generate almost double that amount. Orthopedic surgeons can bring
in $2.7 million on average across their affiliated hospitals. The average
revenue of cardiologists, general surgeons, and neurosurgeons also
exceeds $2 million and it is expected that these specialists will remain
high-revenue generators even with capitation and value-based delivery
models4
.
That’s the good news! The bad news is that the Association of American
Medical Colleges (AAMC) projects that by 2023 there will be a shortage
of up to 90,400 physicians, of which 66,000 will be specialists5
.
If your organization has not started
executing a well-designed, well-funded
physician alignment program, it cannot
compete for the best physicians.
Your competitors, who recognize the
importance of physician alignment, will
capture more physicians.

8. Evariant | 8
Your competitors will be able to capture your physicians (and patients)
because they will have the following tactical advantages…
A database that contains demographic and specialty
information on all the physicians in their (and your)
target market
Continuous access to data and analysis of targeted
physician referral behavior
Better communication with physicians — affiliated or
non-affiliated with their institution — with market insights
to help initiate, frame and focus discussions
A close-looped system to ensure activities are chronicled
and action items addressed, resolved, and communicated
back to the physician

9. Evariant | 9
...to achieve strategic goals and realize incremental revenue by:
Recruiting the best physicians and specialists for the right
geographies at the right time
Ensuring an on-going, enriched physician experience to
keep physicians happy and improve referral rates
Identifying and acting upon opportunities to improve
market share of high-growth, high-margin services at the
right locations
Identifying appropriate entities for mergers and
acquisitions
Building out networks with affiliated physicians
Identifying new delivery channels and services such as
minute clinics and retail pharmacies

10. Achieving
Physician Alignment
Starts at the Top

11. Evariant | 11
The only constant in the healthcare industry is change, which is
driven by on-going dramatic shifts in healthcare demand. Changing
population and disease demographics, an increasingly urbanized
population, unprecedented competition models, the advancement to
patient-centric care, on-going healthcare reform, and the advent of
healthcare consumerism are just a few examples of the forces driving
change. In order to embrace these developments, and simultaneously
protect revenues and ensure continued growth, healthcare institutions
must create an ecosystem that aligns with each physician’s concerns
and ambitions in order to extend its referral network and capture
market share.
The strategy to achieve alignment starts with organizational goals
that are analyzed and incorporated into business development and
physician enfranchisement plans. The strategy for success must start
at the top, and fortunately, today’s health system C-suite executives
are realizing they not only have the ability, but also the responsibility
to contribute to physician alignment efforts. While the physician
liaison program is most likely at the core, anyone who interacts with
physicians is an asset in these efforts. Today, all parts of the health
system can, and should, contribute to alignment success.
Tweet this:
#physicianalignment starts at the TOP.
#CXO’s need to contribute to the effort

12. Evariant | 12
The ultimate goal of a physician liaison program is to increase in-
network physician activity and patient referrals by building meaningful
relationships with and improving services to physicians. The physician
liaison is the steady contact between the healthcare institution and the
physicians. The liaison is a well-trained professional and active listener
with a deep understanding of market trends and the healthcare
system’s services. On a day-to-day basis, the liaison works to cultivate
a trusting, honest, and meaningful relationship — as the health
system’s representative — in order to:
• Improve the referral rates with network physicians
• Identify out-of-network physicians who can bring in new referrals
• Promote the organization’s core and specialty services to drive
increased specialist activity
• Escalate issues voiced by physicians and ensure resolution and
communication back to the physician
• Keep physicians aware of changes in the marketplace
• Communicate new service/policy changes
Achieving physician alignment is a tall order that requires a great
deal of persistence. Results are not achieved overnight, and a “salesy”
approach does not deliver the desired outcome.

13. How Physician Alignment
Has Evolved

14. Evariant | 14
Initially, many physician alignment key performance indicators (KPIs)
were narrowly focused on what could be counted: the number of liaison
visits per week to referring physician offices, the number of social
events scheduled with referring practices, the number of speaking
engagements coordinated, etc. Along with updating sales plans and
weekly sales activity reports, counting weekly activity was the only
way a hospital could measure outreach productivity and ensure the
liaison was spending an appropriate amount of time face-to-face with
physicians developing relationships.
Historical alignment efforts were also simplistic. Many organizations
thought that acquiring Primary Care Physician (PCP) practices would
provide a better opportunity to capture more downstream patients.
Other approaches focused on employing a key specialist or acquiring a
multi-specialty practice so the hospital would get more valuable cases.
Generally, these approaches were an attempt to lock down patient
streams. The problem with these approaches is that any given institution
cannot acquire every practice or employ every physician in its target
market. In addition, it did not focus on the key factor necessary to
actually achieve physician alignment — building relationships.
13
3
8

15. Evariant | 15
Today, there are many “super system” integrated delivery networks
that have emerged from this “land grab” and every health system is
somewhere on an individual journey of building out a care delivery
network, but not just through acquisition and employment alone. The
efforts to secure physician alignment, whether performing in your
facilities, mid-stream in the patient pathway, or all the way upstream
have taken many forms.
What we have learned from almost
every journey is that real alignment is
difficult to achieve.
Tweet this:
REAL #Physicianalignment is difficult to
achieve. Persistence is required for success

16. Tools Necessary for
Physician Alignment

17. Evariant | 17
Three Pillars
of Physician Alignment
What we have also learned over the course of these journeys is that to succeed with physician
alignment, your organization must have three pillars to support the foundation of the program.
First, your organization must have
capabilities. These include an
appropriate set of clinical capabilities
and a reasonable infrastructure and
network of physicians to deliver
care. You also need a good patient
experience and/or the commitment
to continuously improve the patient
experience.
Second, you need human capital, which
includes more than just a physician
liaison. Human capital includes anyone
who interacts with a physician. These
include service line leaders, administrative
executives, other physicians, and other
specialists. You cannot underestimate
the foundational need for and impact
of interpersonal interactions when
optimizing physician alignment.
The third pillar for success — and the pillar
we will focus on for the remainder of this
eBook — is the technical tools, which
includes a deep level of data and enabling
platforms that facilitate physician alignment
analysis and management. We call this
technology a Physician Relation Management
(PRM) system. Sophisticated PRM systems
provide a 360° view of physician loyalty
that incorporates market intelligence and
insights into all physician activity across an
organization’s target market.
1 2 3
Tweet this:
Get a 360° view of physician loyalty across
your hospital’s target market
Capabilities Human Capital Technical Tools

18. Evariant | 18
To help discover a physician’s loyalty, the system analyzes how
a physician interacts with other physicians and how a physician
engages with your organization versus your competition, among other
interactions. The 360° view includes:
Market Physician Roster — This includes physicians across
the specialties the institution needs for outreach — in a
directory format.
Complete Physician Activity — This includes activity of
physicians that are and are not fully aligned with your
organization.
Accurate Referral Information — This is the crux of
a sophisticated PRM system, which integrates de-
identified, individual-level healthcare claims data from
multiple independent data providers. This data is used
to examine patient flow, identify which physicians are
directing patients, what procedures they perform, etc. The
challenges of identifying accurate referral information is
further discussed in more detail in the next sections.
Transparent Physician Relationships — The first three items
above lead to transparent physician relationships, which
includes much more than what the physicians tell us about
themselves.
Market
Physician
Roster
Transparent
Physician
Relationships
Complete
Physician
Activity
Accurate
Referral
Information
View of
Physician
Activity360°

19. Evariant | 19
In addition to providing the 360° view described above, sophisticated
PRM systems must also be able to:
Incorporate a workflow tool to customize the management
of physician demographic information, track liaison
activities, send emails, develop reports and inquiries, and
manage issues. For example*
Provide an architecture that allows the liaison to process a
high volume of activity in a short time. This results in a high
level of utility, efficiency, and ease of use to capture liaison
activities with each physician or with the p hysician’s staff.
Differentiate between high quality and routine interactions
with any given provider. For example, a liaison may have
15 interactions a month with one physician, but only eight
of those interactions are actual face-to-face meetings. For
purposes of analyzing liaison productivity, you only want to
include high quality interactions.
With the support of modern PRM systems, healthcare institutions can
set different KPIs tied to overall system growth and incremental revenue.
Each healthcare organization can configure
a workflow and notification system so
that individuals who are responsible for
resolving an issue are notified, as well as
anyone interacting with the physician who
needs to know about it.
*Support Issue
Management

20. Let’s Talk About PRM and
Market Intelligence Data…
And Its Complexity

21. Tweet this:
See the steps you’ll need to take to identify referral
patterns + get closer to #physicianalignment
Getting PRM data “analysis-ready” is an extremelycomplex process.
To give you a general idea of what’s involved, here is an abridged
example of the steps it takes to identify referral patterns:
Today, no universal source(s) of timely,
comprehensive, detailed claims data
covering all places of service and all
payers (commercial or government)
exists. Claims data is acquired from
multiple clearinghouses that deliver
it in inconsistent formats. As a result,
any market intelligence system must
normalize the data, e.g., put it all into one
consistent format in order to manage it
within one common structure.
Claims are analyzed and grouped to
determine the unique, de-identified
patient ID.
Claims are categorized to determine
their primary purpose, e.g., orthopedic,
dermatology, oncology, etc. This
step is the one of most challenging
because summarizing the myriad of
potential diagnosis and procedure code
combinations requires mass processing
capabilities.
Time sequences are developed based on
each claim’s identifier.
Different clearinghouses use different
identifiers, so this data must be
normalized and duplicate claims
for the same person from different
clearinghouses must be eliminated.
A timeline is created for each patient to
identify which physicians a patient sees
and why.
Each physician’s influence in the
community and the flow of information
based on the timeline is analyzed. PRM
software vendors have developed an
excellent methodology to weigh criteria
to decide who likely made any given
referral based on diagnosis and specialty.
For example, Primary Care Physician
(PCP) Dr. Jones tends to send patients to
specialists Dr. Roberts, Dr. Carr, and Dr.
Williams or the reverse happens.
For example, specialist Dr. Roberts gets
referrals primarily from a named roster
of PCPs. There are many permutations.
Determining the referral influence
patterns is the core of the algorithm.
While it is not the entire answer, the data
provides directional insight that can serve
as the basis for the liaison to ask the right
questions of the physician to get a better
picture of how they refer.

22. The Top 5
Healthcare PRM and
Market Intelligence
Data Challenges
Tweet this:
The top 5 #healthcare PRM + market
intelligence #data challenges

23. Evariant | 23
There are further challenges to effective data analysis resulting from
heterogeneous or missing claims data. Each healthcare institution files
claims, with the data coming from their other Hospital Information
Systems (HIS) or input by hospital personnel at the time of the
encounter or shortly thereafter. Moreover, take into account all the
ambulatory places of service types and it multiplies the variety of data
inputs exponentially. For these reasons, many data elements are in
different formats or are missing. As a result, here are five challenges
necessary to overcome in order to obtain improved data accuracy.

24. Evariant | 24
Challenge #1
Billing Systems Are Fragmented and Dated
An individual healthcare organization can have many billing systems
that are dated and not integrated with each other, their HIS, or EHR.
This increases the chance that some data elements, such as facility
names, can be outdated due to mergers or acquisitions. For example,
Bishop Hospital acquired Helen Hospital three years ago, but many
billing systems have not been updated to reflect the acquisition and
name change.
There’s often confusion between Site of Service names (NPI 2) and/
or billing NPIs that can cause unusual results such as unexpected
site of service names. Providers may be listed as seeing patients at a
practice that clearly makes no sense (such as a vascular surgeon being
connected to a gastroenterology practice). Or, physician names are
listed as the site of service instead of the actual practice name. There
may also be inconsistency in the name of the hospitals. For example,
there can be multiple iterations for and entity like Sharon Regional
Hospital, such as Sharon Regional Hospital, LLC or Sharon Regional
Hospital, llc, resulting from how data is input, programmed, and set up
into the different billing systems.
Multiply the number of billing systems per healthcare system by the
number of healthcare locations within a given target market (where
you are analyzing claims) and the permutations can be difficult to
track. To help address these data challenges, algorithms are developed
that attempt to standardize and convert all possible variations.
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0001101011101010100100000010110100001010
100011000100010000110100010100101000
Hospital A
Hospital AB
!
!
Billing
System 1’s
Data
Billing
System 2’s
Data

25. Evariant | 25
Challenge #2
Patients Do Not Have a Unique Patient Identifier
Experts have argued the benefits and the pitfalls of a unique patient
identifier since the Health Insurance Portability and Accountability Act
(HIPAA) was signed into law in 19966
. Fast forward 20 years and, in
the absence of a unique patient identifier, your organization will find it
difficult to attribute claims to the right patient.
A good example of patient I.D. problems is the result of the mother/
child relationship. Claims for a newborn and/or child are often filed
under the mother’s information, not the child. This is why you may see
some claims for the same individual with different dates of birth, e.g.,
the mother’s and the child’s. This happens for multiple reasons. Some
insurance companies will not issue an insurance card for a child under a
certain age, so the billing system uses the mother’s ID. Or, the newborn
infant has not yet been added to an insurance plan, so claims are
typically submitted under the mother’s ID.
If every patient had a unique identifier, data matching would not be
required. Until and if that happens, data matching mechanisms are
required to look for these data anomalies and put the right patient
claims together.
ID#144000329
{

26. Evariant | 26
Challenge #3
Primary Diagnosis and Procedure Codes Are Unclear
Procedure codes in claims data frequently are not marked as primary,
or multiple codes are marked as primary. This causes confusion when
trying to determine the primary purpose of the patient’s visit. For
example, there may be anesthesiology-related procedures, cardiology-
related procedures, and orthopedic-related procedures on the same
claim and none or all are marked as primary.
Determining the primary procedure is often handled via algorithms
in industry-standard grouper tools that incorporate different
methodologies, workarounds, and external data sources. For example,
Evariant works around this issue with an algorithm that determines
the one “primary” purpose of the claim by using Diagnosis-Related
Groups (DRG) as a foundation and mapping International Classification
of Disease (ICD)-10 and Current Procedural Terminology (CPT) codes
back to summarize the massive quantities of information into useful
service hierarchies.

27. Evariant | 27
Challenge #4
Available Claims Data is Highly Inconsistent
As we discussed previously, there is no universal source of timely,
comprehensive, detailed claims data covering all place of service types
and all payers (both commercial and government). With claims data,
any data field that is not required for payment has a low probability of
being filled in or is inaccurate.
For example, there are fields for “site of service” and “place of service”
on each claim. The site of service is an actual facility (e.g., Smith
General Hospital, Jones Outpatient Clinic), where the place of service
is the type of facility (e.g., hospital, outpatient surgical facility, doctor’s
office, etc.). Neither field is required, so both are frequently left blank
or, due to less payer scrutiny, can be incorrectly completed.
Another example is the use of National Provider Identifier 2s (NPI 2).
Some locations of care are billed under a NPI 2 for a group practice
or master billing NPI 2 related to imaging or radiology. However, the
physicians or labs are located across 15 different sites, which makes it
difficult to identify where care was actually rendered.
To make matters worse, they may all be billed through a central facility
in a different state. So, Dr. Smith may bill out of Charlotte, NC even
though the patient walked into his office in Greenfield, VA. Insurance
companies may not care about site and place of service as much but,
obviously, when using the data to determine referral patterns, these
fields matter.
Patient A
Tweet this:
Big challenge: claims data is often inconsistent
or inaccurate

28. Evariant | 28
Challenge #5
It’s Difficult to Identify the Referring Physician
Increasingly, patients are encouraged, directed and incentivized to
research doctors on their own. But, technology solutions have not
yet advanced far enough to accurately capture or even quantify self-
referral activity by patients.
For now, most referrals are physician generated, but as previously
mentioned, billing systems and EHRs are often not integrated so
capturing quality referral input is extremely difficult. The “referring
physician” field on available third party claims is often inconsistent,
incorrect or, most often, missing. For example, a patient presents
at an Emergency Room (ER). The admissions staff may ask for and
enters the patient’s PCP in the “referring physician” field. In fact,
some clearinghouses don’t even provide the “referring physician” field
because of these inconsistencies.

29. Better Data Equals
Better Physician
Alignment
Tweet this:
#Hospitals need every advantage to keep & grow market
share. Better #Data = better #physicianalignment

30. Evariant | 30
“The Affordable Care Act’s emphasis
on quality outcomes, satisfied patients,
cost-effective care and continuous
improvement, which is the reality for all
hospital leaders today, is grounded in
the availability of meaningful data and
leadership’s ability to analyze and use it
to benefit patients and themselves.”
—Dr. Dighton Packard
Becker’s Hospital Review7
Your healthcare organization needs every advantage to stay
competitive in today’s market. What separates the enterprising
healthcare institutions from the ineffectual ones is the ability to access
physician and claims data, segment and analyze it to gain actionable
insights, and execute on those insights. Acting on data dictates which
healthcare organizations gain market share and which organizations
lose market share, which make money and which lose money.

31. Evariant | 31
One Chicago-based health system believes that data is a key
component to achieve physician alignment. Data empowers their
physician liaisons to successfully engage physicians and influence the
organization. The key to its success is not to just capture the data, but
to fix any erroneous or incomplete data at the source, even before
using it. To help improve consistency in a system where 900 individuals
were entering referral data, the institution improved its EHR system
and other operational processes by standardizing the format and
instructions for data entry fields in order to enhance referral tracking
and communication flow back to the referring physicians.
Once the data was fixed, the health system developed a repeatable
process for strategic planning and outreach. It used both internal and
external data to analyze opportunities for deeper alignment, to tailor
their messages to potential referring physicians, and to monitor both
the outreach and the outcome.
This health system is an excellent example of how to utilize data
and analytics to achieve the physician alignment goal. While this
organization is still in the midst of implementation, it has already
increased revenue from 23 referring physicians by 845 percent in FY15
from $718,000 to $8.5 million.
Dignity Health’s year-over-year
incremental revenue contribution grew
to $56M after incorporating this sort of
data-driven approach into their strategic
outreach planning.
Success stories from
other health systems
Read the whole story

32. Evariant | 32
Conclusion
It is not surprising that healthcare executives
are rating physician alignment as a top concern.
In a recent article published in Hospitals and
Health Networks, the authors state, “As the
market shifts toward financial incentives for
quality, cost control and experience, closer
collaboration between physicians and systems
becomes a necessity. Even organizations
that are primarily focused on fee-for-service
strategies are reconsidering physician alignment
with an eye on the value-based future.8
”
However, it is important to recognize that the
methods and technologies you need to support
a successful physician alignment strategy have
changed over the years and today they are
changing at a faster rate.
Before PRM systems were developed, a
healthcare organization was lucky if it had
access to a database that contained physician
contact information. Even if one existed, it
often only contained information about internal
physicians. Aside from contact information,
most other “intel” about a physician was
provided by the physician when meeting
with the liaison. The more sophisticated
liaisons would document these findings in
spreadsheets. Some institutions still rely heavily
on Excel as a way of collecting and recording
information.
Even today, many PRM systems only provide
data about physicians already employed by or
associated with their healthcare system and
any “analysis” only includes certain types of
internal data. The problem with this approach
is that an institution “doesn’t know what it
doesn’t know.” There is no view into physicians
outside of the healthcare network and even for
affiliations, there is not enough depth of data
and actionable insights.
Today, rapidly advancing data analytics ushers
in a progressive era for physician alignment.
Now more than ever, your institution can
achieve a view into all physicians in your target
market, analyze their claims data to discover
their loyalties, engage in more meaningful
dialogue, identify and resolve physician issues,
and build relationships based on respect and
trust. And all of this has the potential to give
your institution the competitive advantage
it needs to achieve successful physician
alignment, increase volumes and referral rates,
and realize incremental revenues.
Tweet this:
Tips on giving your organization a
competitive edge when attempting
to achieve #physicianalignment

33. Like this eBook?
Take a moment to share it on your favorite
social networking sites.

34. About Evariant
Evariant sees a future where healthcare organizations deliver precise, efficient
care solutions not only inside an organization’s walls, but also beyond. We make
this a reality by continuously innovating a healthcare CRM platform—a platform
based on a centralized healthcare data hub, analytics, and communications
engine—capable of identifying, executing, and measuring all types of
engagement initiatives.
With the Evariant Physician Relationship Management (PRM) solution,
healthcare organizations can understand physician network trends, prioritize
and better target physicians, and drive referral volume and in-network
physician activity.
Evariant believes that connecting insights that inform engagement will
transform the healthcare experience.See it in action
Contact us for more information.
888-444-3598 | evariant.com | connect@evariant.com

35. Sources
1. Collier, Matthew and Basham, Leslie Meyer, (2015) Accenture: Patient Engagement:
Happy Patients, Healthy Margins. Retrieved August 31, 2016 from https://www.accenture.
com/t20151003T033201__w__/us-en/_acnmedia/Accenture/Conversion-Assets/
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