The cost of your growth strategy

How Much Is Your Growth Strategy Costing You to Not Deploy?

Most health system CEOs know their growth strategy has an execution gap. What they haven’t done is put a number on it.

There’s one question I ask in almost every first conversation with a health system CEO. Not about strategy. Not about the competitive landscape. Just this: what is your referral leakage costing you per quarter?

Most can’t answer it. Not because the data doesn’t exist — it’s sitting in your EHR, your PRM, and your claims system. It’s never been integrated, attributed, and surfaced in a way that produces a number the CFO can actually use.

Studies show 30–50% of employed PCP referrals leave the network, with the exact rate varying by market, specialty mix, and system size. For most health systems, referral leakage routinely exceeds $100M annually. At the median operating margin of around 1% — Kaufman Hall tracks this quarterly — recovering even a fraction of that volume doesn’t just improve the growth line. It changes the financial profile of the organization.

Now ask the second question: how long has that leakage been running at this rate? If the answer is two years, three years, or longer — the cost of not deploying your growth strategy isn’t a future risk. It’s an accrued loss.

Most health systems know they have a leakage problem. Many have commissioned studies that confirm it. Some have strategies that address it — sitting in a slide deck, waiting for an implementation that never quite gets resourced. The gap isn’t awareness. It’s deployment. And deployment requires something most strategy engagements don’t include: a live analytics infrastructure that makes the leakage visible in real time, outreach programs that are actually running, and someone accountable to the volume outcome — not the deliverable.

The systems that have closed this gap didn’t commission a better strategy. They built the infrastructure to run the one they already had. That’s a different kind of engagement than most CEOs have been offered.

If you haven’t put a number on your leakage yet, that’s where we start.