Drivers of revenue in specialty outreach clinics

This study analyzes the downstream hospital revenue generated from a series of specialty outreach clinics. Using a specially collected time-series database I show two distinct patterns, depending on the clinic's specialty. One specialty type provides an immediate impact to the hospital in the form of primary downstream revenue. The other specialty type provides a delayed impact, with downstream revenue occurring mostly in departments not associated with the sponsoring department's medical specialty. Further, the impact of structural drivers such as distance differs by the type of clinic considered, implying a need for tailored performance measures. This implication is underscored in my analysis of cross-sectional data. This analysis shows that executional drivers such as the clinic's age and the frequency of visits matter more for some clinic types than others. Finally, results show clinic type affects the magnitude of the differences in the influence of the executional drivers on clinic-level profitability and downstream revenue generated. I infer that the cost-benefit from using local clinic-level metrics to manage global revenue and profit depends on the clinic type. Overall, my results suggest caution in developing performance measures that include financial impact in other organizational units---context matters even in a relatively homogenous setting of specialty clinics in one hospital system.