Article Title

Patient Loyalty in a Mature IDS Market: Is Population Health Management Worth It?

Publication Date



organization and delivery of care, physician payment


Background/Aims: The objective was to understand patient loyalty to providers over time in order to inform effective population health management. We studied patient care-seeking patterns over a 6-year timeframe in Minnesota, an environment where care systems are motivated to practice population health management through shared-saving contracts with public and private payers.

Methods: A regional health plan provided data from their administrative files, matched to U.S. Census-based characteristics of the patient’s neighborhood. Patients were retrospectively attributed to health care systems by the health plan based on patterns of primary care. 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.

Results: We found 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 longer when their care system provided primary and multispecialty care.

Conclusion: Continuity of provider-patient relationships mean population health management can be beneficial to the care system that makes 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.




July 5th, 2016


August 12th, 2016