Problems › A Competitor Is Taking Our Customers › Healthcare Providers
Losing attributed lives to a competitor is a positioning question far more often than a reimbursement one, and the two need opposite responses. The version of this question that applies to healthcare providers is not the generic one. Downside risk has been accepted on 38,000 lives without the cost-per-episode data needed to price it — so an answer that ignores cost per episode will be confidently wrong. The analysis has to start from payer mix and panel size rather than from revenue.
Losing attributed lives to a competitor is a positioning question far more often than a reimbursement one, and the two need opposite responses. The version of this question that applies to healthcare providers is not the generic one. Downside risk has been accepted on 38,000 lives without the cost-per-episode data needed to price it — so an answer that ignores cost per episode will be confidently wrong. The analysis has to start from payer mix and panel size rather than from revenue.
When a competitor starts winning attributed lives, the first explanation offered inside the organization is always reimbursement. It is occasionally true. More often the competitor has picked a narrower promise around cost per episode in one area and is beating you inside it, which looks like reimbursement to the medical director or CFO because that is the last term negotiated before a contract moves.
The distinction matters because the responses are incompatible. If it is genuinely reimbursement, you either match the rate and reprice the whole book of value-based contracts or you accept the loss of that segment. If it is positioning, matching the rate funds their advantage while destroying contribution per provider.
The way to tell is unglamorous: the reasons recorded on the last twenty lost attributed lives, segmented. A reimbursement problem shows up everywhere. A positioning problem clusters.
These three together are the signature. One on its own usually points somewhere else.
✓ Lost attributed lives concentrate in one payer mix or one episode type rather than spreading evenly across the panel
✓ The medical director or CFO requests authority to adjust contract rates rather than different cost-per-episode proof
✓ The competitor is smaller and more specific in the episodes it takes under value-based contracts
The move that usually makes it worse. Meeting the reimbursement rate and keeping the positioning, which loses contribution per provider and the argument at the same time.
It is for you if you run or finance a healthcare provider and losses concentrate in one segment or one use case rather than spreading evenly. It is the situation where the numbers are available but nobody has put them in an order that produces a decision.
It is not for you if Percision is the wrong tool if you already know the answer and only need execution capacity, or if the business is pre-revenue — then the constraint is evidence about the market, not analysis of your own figures. Percision is not a lawyer, tax advisor, auditor, licensed appraiser, clinical or regulatory filer, or an AI implementation shop. It does not do HR casework, creative-only brand work, or impersonate a named consulting firm. It is a strategy analysis engine — not a template library. Also wrong if you need facilitation, politics, or someone to sit with a lender or buyer. Those are human jobs.
Percision is not a lawyer, tax advisor, auditor, licensed appraiser, clinical or regulatory filer, or an AI implementation shop. It does not do HR casework, creative-only brand work, or impersonate a named consulting firm. It is a strategy analysis engine — not a template library.
Below is an excerpt from a real run of this analysis on a healthcare provider. It is a sample profile rather than a customer, and it is unedited engine output — this is the format you get, on your own numbers.
The subject is Cedar Ridge Health Partners, a sample company profile used for testing rather than a customer — 38,000 attributed lives under value-based contracts.
Excerpt from a real Percision run · Quick Market Scan · sample company profile
The move. Sell coordinated care bundles directly to self-insured employers using existing clinic density and ASC capacity.
The leak it closes. Bypasses commercial payer take-rate (estimated 15–20% of premium) and prior-authorization friction, reducing denial leakage on these lives to near zero
The assumption it rests on. At least two of the five largest self-insured employers in the two metros will sign a 3-year direct contract within 18 months — the engine put the probability at 0.7.
| Investment required | $2M over 36 months ($800K Year 1, $700K Year 2, $500K Year 3) |
| Expected return | 6.0–9.0× on $2M investment |
| Revenue, year 1 | $0 incremental (pilot setup and first contract negotiations) |
| Revenue, year 2 | $4–6M incremental (2–3 employer contracts, 4,000–6,000 covered lives) |
| Revenue, year 3 | $12–18M incremental (5 employer contracts, 10,000–15,000 covered lives) |
| Exit criteria | Terminate pilot and redeploy 4 FTEs if fewer than 2 employer contracts signed by Month 18 OR if operating margin on employer channel falls below 6% for two consecutive quarters |
This is one move out of a full analysis. Read a complete report — every page, no email required.
This question routes to Competitive Benchmarking & Positioning, one of 29 engagements the platform runs. For healthcare providers it works through cost per episode, payer mix, panel size and contribution per provider, then produces the sequence rather than a list of options — which move first, what it funds, and the observation that would say the sequence is wrong.
You watch the analysis get built before paying anything. Read a complete report here if you would rather see the depth first.
Only if you can serve that segment at their price and still make money, and only if you are willing to reprice the customers who already pay you more. A selective match is usually a promise you cannot keep once the market notices.
On specificity, not on breadth. A better-funded competitor can outspend you everywhere and cannot out-focus you in one place, which is why narrowing the promise usually beats broadening the feature set.
Then the honest answer is a product decision with a timeline and a cost, not a marketing response. The damaging outcome is spending a year on messaging for a gap that messaging cannot close.
Materially, yes. Downside risk has been accepted on 38,000 lives without the cost-per-episode data needed to price it — which changes both the diagnosis and the order of the fixes. The metrics that decide it here are cost per episode, payer mix, panel size, and an answer built on industry-general benchmarks will usually point at the wrong one first.
Less than most people expect. Your last twelve months of revenue and cost split the way you already split it, plus whatever you hold on cost per episode and payer mix. The analysis is explicit about what it is assuming where your data stops, which is more useful than waiting for numbers you may never have.
Percision is the wrong tool if you already know the answer and only need execution capacity, or if the business is pre-revenue — then the constraint is evidence about the market, not analysis of your own figures. Percision is not a lawyer, tax advisor, auditor, licensed appraiser, clinical or regulatory filer, or an AI implementation shop. It does not do HR casework, creative-only brand work, or impersonate a named consulting firm. It is a strategy analysis engine — not a template library. Also wrong if you need facilitation, politics, or someone to sit with a lender or buyer. Those are human jobs.
Percision is not a lawyer, tax advisor, auditor, licensed appraiser, clinical or regulatory filer, or an AI implementation shop. It does not do HR casework, creative-only brand work, or impersonate a named consulting firm. It is a strategy analysis engine — not a template library.
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