Patient Loyalty in a Mature IDS Market: Is Population Health Management Worth It?
Version of Record online: 24 JAN 2014
© Health Research and Educational Trust
Health Services Research
Volume 49, Issue 3, pages 1011–1033, June 2014
How to Cite
Carlin, C. S. (2014), Patient Loyalty in a Mature IDS Market: Is Population Health Management Worth It?. Health Services Research, 49: 1011–1033. doi: 10.1111/1475-6773.12147
- Issue online: 16 MAY 2014
- Version of Record online: 24 JAN 2014
- Medica Research Institute
- Consumer issues;
- physician payment;
- organization and delivery of care
To understand patient loyalty to providers over time, informing effective population health management.
Patient care-seeking patterns over a 6-year timeframe in Minnesota, where care systems have a significant portion of their revenue generated by shared-saving contracts with public and private payers.
Weibull duration and probit models were used to examine patterns of patient attribution to a care system and the continuity of patient affiliation with a care system. Clustering of errors within family unit was used to account for within-family correlation in unobserved characteristics that affect patient loyalty.
The payer provided data from health plan administrative files, matched to U.S. Census-based characteristics of the patient's neighborhood. Patients were retrospectively attributed to health care systems based on patterns of primary care.
I find significant patient loyalty, with past loyalty a very strong predictor of future relationship. Relationships were shorter when the patient's health status was complex and when the patient's care system was smaller.
Population health management can be beneficial to the care system making this investment, particularly for patients exhibiting prior continuity in care system choice. The results suggest that co-located primary and specialty services are important in maintaining primary care loyalty.