And hello and welcome everyone to the Shishmid webinar supporting service line growth and development with the power of data. Shishmid would like to extend a sincere thank you to Optum for sponsoring today's program. His webinar is now being recorded and is broadcast in listen only mode. We have designated time.
Time at the end of this webinar for Q and A feel free to click the chat icon in the lower right hand side of your screen to submit questions or comments throughout the presentation. It is now my pleasure to introduce today's speaker. We're speakers we are joined by Joshua Stout, who is the market research manager at Guthrie Clinic and Amanda Johnson, who is strategic solutions advisor at Optum. Joshua and Amanda, thank you so much for joining us. The floor is yours.
Okay.
Wonderful. Well, thank you so much, Tom, for that introduction there, and I just wanna start off by saying good afternoon to everyone and thank you all for choosing to spend part of your afternoon with Josh and I today, and another big thank you to Shashmed for helping to host us today. What we're here to do and discuss is really talk.
Walk through the power of how the Guthrie clinic was able to leverage multiple OMA data sets to help inform strategic planning initiatives specific to their physical therapy service line.
So, before actually diving in today, I just wanted to start off by doing some more formal introductions to myself and Josh and then giving the group a nice high level overview of what we're actually going to be focused on and walking through today. So with that said, once again, my name is Amanda Johnson I'm.
A strategic solutions advisor, a part of the Optum market advantage team. Outside of my experience at Optum I have experience within quality and process improvement, and I have had the privilege of getting to work with the Guthri team for approximately two and a half years now, so just really excited to be co presenting with Josh today.
And with that, I'm gonna hand it over to you Josh.
Yeah, thanks Amanda, and thank you to Shishmed for having us today. I'm Joshua Stout micro research manager for the Guthrie clinic, and I've been with the organization for about eight and a half years working on strategic initiatives and market research. Prior to this, I spent about three and a half years in strategy.
On the payer side of health care with a large insurer here in Pennsylvania. And we're excited to share with you all just one of the many ways that we leverage our partnership with Optum for strategic decision making here at Guthrie, and with that, I'll hand it back over to Amanda. Yeah.
Thank you for that Josh. So once again, just to briefly walk you all through how we're gonna approach today's session, we're gonna kind of kick us off with 1st what exactly is optumarket Advantage and walk through some common use cases we see with clients just so that you all can get a sense for the actual data set that Josh is gonna.
To be walking us through today. From there, we're then gonna get into a little bit of background on Guthrie Clinic and give a high level overview of the use case that Josh is going to be walking us through shortly after that. I'm then gonna hand it over to Josh to go through each of the different data sets and call out some key insights that helped inform.
Of their strategic decision making for their physical therapy service line, then Josh is gonna hand it back to me to kind of just review some key takeaways and next steps for the Guthrie team before closing out on some Q and A at the end here. So without further ado, hopping right into what exactly is Opta Market advantage and or OMA. And OMA is a claims based market intelligence tool that really allows for our clients to be able to get a sense for how they're performing in the market in comparison to peers from a strategy.
Perspective. So just to share the type of folks that we work with, we usually work with folks within strategy, planning, business development, and work with them on a multitude of use cases. So anything from comprehensive strategy reviews to service line development and, you know, looking at providers and provider related.
Relationships across their markets, and a lot more so we thought it would be worthy to just cover some of those common use cases that we see from some of our clients. So on this next slide here, before hopping into some of those common use cases, I just want to give you all some brief history on the OMA tool and actually historically the OMA tool was primarily used for physician outreach and really focused on physician documentation and understanding how to.
To retain and grow physician relationships within the market. But as you can see on the slide here across the last few years, we've really honed in on that strategic planning space. So you can see anything on this list here from our clients coming to us for use cases focused on footprint growth. So, e.g..
A client coming to us saying, hey, we want to understand or we're interested in growing our orthopedic service line. What opportunity presents the best market for us to actually grow and expand that orthopedic program? Another common use case that we see would be, e.g., a new service offering. So maybe our client has a really robust ortho.
The Pedics program, but they're currently playing around with the idea of offering say padiatry services within the market. What does that competitive landscape actually look like within padiatry and how or e.g., where are patients choosing to go for those physical therapy services?
Another interesting use case to cover here that we've seen a lot within the last year or two would be practice group evaluations. So looking at, you know, not only those groups who we have, let's say an official partnership with, but even some of those unofficial partnerships with. So, e.g., maybe we have this.
GI group who we've been entirely relying on to bring GI business into our four walls. Is it truly the best decision to continue to work with this group or the best care GI care possible by working with this group for with our patients and for us as a system? Or should we be looking at other.
Their groups or even looking at developing say our own in house program. So these are all the types of questions you can play around with, within the OMA tool. But this is not an exhaustive list. We always encourage our clients to come with us, come to us for new business or use case questions, but thought it would be interesting to cover with you all.
Today before actually getting into what we're gonna be walking through with Guthrie. So diving right into here, I wanted to give you all some brief background on Guthrie. So Guthrie is a not for profit health system with five hospitals as well as a large outpatient network located across northern PA as well as Central New York. Another fun fact about Guthrie is.
Because they have actually been partners with OMA for the last nine to ten years. So you can imagine how difficult it was to decide which project or deliver what we really wanted to focus today for this presentation.
But ultimately what we ended up going with was the Guthrie team, they were really looking for data to help aid them in their strategic planning initiatives specific to their sports medicine program with a focus on physical, their physical therapy service line. And the reason we decided to go with this use case is we.
We thought that this case in particular did a really good job of highlighting how the Guthri team was able to take multiple different data sources to paint a really powerful strong picture of true opportunity for their physical therapy service line across their markets of interest. So.
Getting into some of those specific data sources before passing it along to Josh, 1st off, the Guthri team was able to leverage what's called our OMA attending data set to get a sense for what physical therapy services presented the greatest revenue opportunity within their markets. So for the group's knowledge, our.
Pending data, what we're looking at there is the ordered and performed business by specialists within the market. So the gut through team was able to take that data, look at that business being performed by specialist and really get a sense for those services and understand average contribution margin to see if those services were actually worth capitalizing on.
So, more detail to come from Josh there. Some other data sources that Josh looked into within the OMA data set was looking into our longitunal data, which is considered to be our patient centric data set to get an understanding of where patients were choosing to go for their physical therapy care.
This helped them to, you know, in their assessment for understanding potential practices for acquisition for physical therapy, as well as some other data sources such as looking into the front end of our tool to understand what volume looked like within specific practices etc.
And then the next data set that Josh is gonna be discussing today is our PCP referring data. And what we're looking at with that data is the downstream business, in this case, downstream physical therapy business that came from PCPs within their markets of interest. And Josh will get into more of this.
On the next coming slides, but really being able to understand how well aligned both Guthrie PCPs were as well as non guthrie PCPs to understand if there was opportunity to pull some more of that physical therapy business back into ensure optimal PT care for patients. But with that said, I'm gonna go ahead and hand it off to Josh to start going into some more detail and and insights captured.
Thanks, Amanda. We at Guthrie are a very data driven organization, and our partnership with Optum is one of the many ways.
That we use data to inform and support our strategic planning processes here. When Amanda had asked me if I had any good case studies we could showcase our approach to leveraging data in decision making, the issue really was less of finding one example, but more around which of the many we've used.
1st of four did we wanna bring to this group to show? To provide a comprehensive look into our approach, we landed on sharing a very recent example of how we are using OMA data in our current sports medicine strategic planning process. Really, as Amanda has said, with a focus on PT and rehab in particular.
Now, due to the nature of this service line, being a non surgical service, our other market data sets have avoid here, so our entire external database approach really hinged on using the full suite of the OMA tools to garner insights.
PT and Rehab also historically wasn't the department we had done a lot with in the past, so we wanted to approach this from a bird's eye view and drill down deeper as we progress through the data cuts.
And that brings me to this slide. The 1st tool that we leveraged was the attending data to see by service what was the total market value of outpatient ET and rehab care generated by all providers in our market regardless of their specialty.
So if I can orient you to the table on the right of this slide, you'll notice the service or procedure in the 1st column followed by the respective market value within each of those services.
This gives insight into which services have the highest revenue being generated within our market. In this case, it's manual therapy. Following that, another benefit of this cut was we could see what the average contribution margins were for those services.
And you'll notice I called some of those out in green, which had the higher profitability. Then in the column furthest to the right, we see what proportion of that care was being performed at a Guthrie practice. So from this, as you can see, there were a handful of services that appeared to generate higher profitability.
That our capture was fairly low, which then led to discussions with the group around, is there the ability to further target any of these procedures? And if so, what would it take to target those? Is it more staff? Is it expanded training or certifications or are there equipment needs?
Or maybe there's other factors to consider regarding expanding those service offerings. But this data set was our 1st look into that initial approach of understanding the market. Our next view was utilizing the PCP ref.
Occurring data, which is a PCP centric view from a geography perspective. While we can see this for any PC practice within our market, in this cut, we wanted to look specifically at our employed PCPs. We wanted to see what was the downstream revenue being shared by them in each region that's highlighted in the orange along the top there of the table.
And of that, where was that care going? To show that if I can direct your attention to the blue highlight there, we can see within our twelve county service area, 31 % of that downstream care was being shared with a Guthrie provider.
Now to add some perspective around this alignment, we aim to have our PCPs at least 70 % aligned with our specialists, so seeing lower numbers related that revealed that while these patients maybe choosing Guthrie for primary care.
A notable portion aren't using to receive PT and rehab care at a non Guthrie practice. So with this cut, not only did we wanna know where that care was going, so we could try to understand the reasons why, but we traditionally use this downstream data set as a primary driver for our physician liaison team in identifying those areas.
Where patients are leaving the system for care, that way they can focus their efforts on understanding what maybe driving this and are there tactics we can implement so that those patients don't feel like they need to leave for care if they would prefer to stay within the Guthrie system for that?
Ultimately, the goal when appropriate is trying to deliver the full continuum of care at Gutherry so that we can provide seamless and well coordinated care across all of the patient needs. And this data set helped us understand that.
Then flipping from the provider centric to a more patient origin lens, we transi transition to the longitudinal data set to see where patients from our various regions were going for this PT and rehab care.
This data set includes numerous variables that allowed us to really further refine the potential market we plan to go after. This then became our final market share metric, which we found in our central region where we tend to see stronger market share.
We were only capturing slightly over a quarter of the market. It also showed us which region was the capture more concentrated to a specific practice. As you can see, that's the case in the central region verse which regions were more fragmented with numerous practices.
Having smaller pieces of the market. That was more so the case in the western region than some of the other regions we looked at. Now that we knew who the large competitors were in each of our markets, we were able to perform a qualitative assessment where we compared Guthrie PT and rehab services to services of some of these top competitors within our market.
From this research, we had found in some of our markets, these competitors were offering better extended hours in other markets, we had found that they were offering group therapy sessions. So having this data allowed us to really narrow our efforts to focus on comparison.
Bring our services to those market leaders as opposed to having to look at every single practice within a region to compare against. And then one final benefit of this view was knowing every practice's market standing, so if we were interested in a partnership or acquisition, we knew how strong they were in the region, which I'll get into an example of that more on my next slide.
My final ground level view of leveraging the data was looking specifically at a PT practice that there was interest in acquiring. For this specific practice, we were asked to provide some market insights that could be supplemental to a performer process.
Using our OMA dashboard, we were able to conduct a 360 degree view into the practice through the claims data. From the previous longitudial analysis that I'd shown on the prior slide.
We knew that this practice had yielded a 3 % market capture in our western region service area. We could see the total book of business for this practice, $460000, which is shown in the center of that blue circle, and what PT services was it performing? That would be the table under that circle.
We also looked to see how many providers were contributing revenue to this practice, and in this case, it was just one provider. Finally, we wanted to know who were they sharing patients with. That's the table over to the right.
Showing that. In this, we saw some of our orthough apps were already sharing patients with them as well as some of the key non guthrie PCPs that we had good relationships with. Knowing all of these details.
Is very helpful in decision making and a component that can be ancillary to a performer process, whether it be looking at the practice valuation or assessing the feeder sources and volumes to the practice. So with that, now that I've walked through the different data components that a.
Did us in our strategic planning process for this PT and rehab example. I'm gonna hand it back over to Amanda to summarize all of our findings and close this out.
Absolutely. Thank you so much Josh, for going through all the different data points with the team. So just to kind of give a recap and highlight once again those overall insights that were captured within the data from the team, the Guthrie team and Josh was able to leverage the data to identify specific physical therapy services that the guthrie.
Reclinic actually had the ability to start offering, one of those being self care training, which the Guthri team and Josh had mentioned with some training, it was an actual service that they could end up looking at pursuing in the future. Something else that was called out is how the Guthrie team was able to, you know, highlight that.
Got three PCPs were not really well aligned when it came to physical therapy services, and that was there was truly a lot of opportunity to improve network integrity there to ensure patients were staying within the system to get that PT care, to ensure that, you know, care journey and quality of care for patients was positive.
And really increase that downstream business. The Guthrie team was also able to target top competitors that patients were choosing to go to for their physical therapy services, which further motivated that team to do additional research and understand what were their competitors doing differently that they weren't doing today? How can they be kind of that best in class physical therapy?
Center four patients to be going to. So, as you can see, all of those insights today really showcased how the OMA data was able to effectively support the Guthri team in strategic planning for their physical therapy service 1st service line. But the real strength and power of this case lied in Guthrie's ability to integrate the various data.
Sources to create this comprehensive view of opportunities for their physical therapy service line. And really this holistic approach allowed for the Guthri team to make informed and thoughtful decisions that helped to support Guthrie's strategic direction for physical therapy. So as you can see, the power of data not only helped to drive.
This project specifically, but the power of data has also helped to underpin several Guthrie initiatives in several different project work that we've done together ensuring that they're consistently making well informed choices for delivering top quality services and care to their communities. So, with that, we now want to open it up to the group for any questions that you all have for Josh and I.
Great, and thank you Joshua and Amanda and just a quick reminder that if you do have a question, please feel free to just put it in the chat.
Great, so I see one question came in here saying, what were some of the most surprising findings within the data? And I'm gonna go ahead and pass that one to you Josh.
Yeah, yeah, I think as we mentioned in one of the slides, where we saw a difference in what we were used to in one of our core regions, was that lower capture and lower alignment, so that in itself.
Was surprising for us to find and it really kind of helped fuel discussions around what strategies do we want to put into place to get that up and be more aligned with what we're seeing across the system with some other services in that capture in the core market.
Awesome, thanks for that Josh. I see another question came in asking, how do you ensure that the data collected and shared is both accurate and actionable? So this one I can tackle here. So, one thing that we always like to emphasize and educate our.
Clients on when they're using the OMA data is that the data is meant to be used directionally. So not getting so hung up on the exact numbers but being able to pull insights and tell a story based on what we're seeing within the data, right? And just to add there in terms of, you know, the accuracy of the data.
We always, we do essentially these data refreshes where our team is doing, you know, QA checks to make sure that data, you know, is looking good and if there's any issues of course we always bring to clients and such.
And then, yeah, so that's what I would say in terms of making sure accurate, and then in terms of being actionable, once again, so with the data, while it is meant to be used directionally, our clients have been able to tell really powerful stories in terms of the several different use cases we talked through today with that data. So, that's how I would answer that question there. But any other questions from the group?
Yeah, I I see one here, to what extent did marketing play a role in Guthrie's strategy to capture share from competitors? So here at Guthrie, actually our strategy team is embedded within the same department with our marketing and position leaders and outreach program. So we really work on everything step in step with one another. So we'll look at market data to help marketing determine.
What are some of the messages that are most important to consumers? What are some of these services that we know we can deliver high quality care on? And with that they can launch either campaigns that are directed to consumers or they will also assist our liaison team in materials so as they go out and build relationships with.
With community providers, just letting them know, hey, this is what we offer, this is the quality care we offer. So we really do work quite closely with our marketing counterparts here. Hey, Gatherine.
Yeah, and I see a couple more questions came in. This next one I'll tackle Josh, but then also hand off to you to add any color here. So I see from Jason Schaefer, does Guthrie perform routine review and manual updates of the opt in data such as provider updates as they transition from one facility to another? So just to give my input there, working so closely with the Guthrie team, we do oftentimes will either work with the liaisons.
To look at the data and they'll give us any, you know, updates that need to be made to the roster so that we can ensure we have, you know, physician employment statuses updated specialties updated et cetera. And then also I know Josh is really great at validating that as well and take some of his own tactic tactics, so I'll hand any color to add there Josh, from your perspective.
Yeah, yeah, thanks Amanda. Yeah, the data's great. What we always always like to do is on the back end, we perform annual updates to who are all the providers in the market so that way we can always cross reference that with the data coming through and just ensure that as we're analyzing data, it's aligned with everyone.
In the market and what we're seeing as well. Yeah.
Thanks for that Josh. I see another question came in. How did you use this data with your outreach strategy with your physician liaisons?
Yeah, yep, so not just specific to this PT, we really use this data. It's one of, as I mentioned, the key drivers to our physician liaison program. So that way as they're going out and they're talking with our employed PCPs with non employed PCPs, what are those referral patterns look like? So when they're discussing with these providers.
What, what are you looking, what are your patients looking for? We know what those care patterns look like and we can go into those locations really understanding what's our value proposition specific to a given service line. And to do that, as I mentioned before, they maybe supplemented with some marketing materials or.
They will also bring along some of our specialists to do outreach. I think one of the biggest things is really building those relationships and having our specialists go to these, these primary care providers, establish those and foster those relationships. That way those primary care providers, they know who they're referring to. They know that their patients are in good care.
So all of this data really helps build out that broader strategy of the liaison outreach program.
And then this goes along pretty nicely with the question that you just answered Josh. It's a little related here. So how did you utilize the findings to strategically deploy liaisons to influence and redirect referral patterns?
Yeah, yeah, I I think that, yeah, kind of goes back on just my my previous response right there and really everything about their outreach is data driven, so they know where to spend most of their time to really focus on building those relationships and the data tells us.
Where to go, where, where those care patterns are going and and really what to focus on.
Yeah, and just to also add some color there, we also have, you know, myself, I meet with the liaisons as well, and they're also well versed in being able to take a look at, e.g., the network connections data that we talked about earlier, and have been able to analyze, you know, what.
Wrong relationship patterns exist, et cetera. And so they're really well versed in the data as well yeah.
I see another question. What actionable steps did you take to expand into a new market? New services, expanded hours? What specifically were some of the recommendations you made to senior leadership? So regarding this use case that we had shown today, this is a.
The fiscal 25 initiative that's underway. So we are still engaging in this strategic planning process as it relates to physical therapy and rehab, but there are previous other service lines throughout my tenure here in partnership with Optum where we've used this data to go into additional markets. We've, we've expanded our service area into a couple counties of broadley Reach since I've been here and this is always a one of our data sets that we heavily utilized.
As well as admissions procedures data so that when we're going into a new market, we know from the PCP referral perspective, where's that care currently going? Is some of that maybe actually coming to us already or is a lot of it going to a key competitor? Is that competitor to local, is it regional? So having some insight into the market we're about to enter really helps us better.
Plan for a successful launch and entry into that market.
I see another question came in. What were some of the biggest barriers you encountered when deploying this strategy internal or external?
Yeah, so I'll say, with this one, as I, I mentioned that we're still in the process with planning this, so more to come on that.
In terms of if you're kind of asking relating to the data and rolling that out to the organization, our organization has been very receptive and great at understanding all of the data sources we use, what they tell us, what they maybe don't tell us, and they just do a great job with.
With understanding that there are different pieces of data sets that we'll pull and that there isn't really one given data set that will tell that whole picture. So we really go across multiple data sets to try to show a holistic view and I think our organization is very comfortable with how we've rolled that out and being very clear.
Insurance parent with what each data source is, how we use it, when to use it or when to look at using an alternative data source.
Looking to make sure we didn't miss any questions here. All right, does anyone else have any other questions for myself or.
Josh?
And Amanda and Joshua let me just step in and say thank you both very much. We'll give people a few seconds here if they want to put in another question, but just wanna say thank you both. Thanks for sharing your expertise with us today and some really great information and thank you again to Optum for sponsoring today's program, and I just want to let people know that there will be a survey that will.
Launch on your browser once this webinar closes, and I will share a recording of this webinar and slides later this afternoon. So I don't see any other questions, Amanda Joshua, any parting words before we close out?
Just thank you all again for joining in this afternoon. We appreciate everyone's time.
Yeah, very appreciative for the opportunity. So thank you. Thank you, Tom, thank you Shushmatt, thank you, Amanda Optum, and everyone else who joined in to listen.
Alright well thank you very much and thank you everyone for joining. Have a great rest of your afternoon.
You all as well. Everyone take care. Bye.