Alpha Sophia
Your market dynamics · One-time report · No subscription

Which practices are sending your cases elsewhere?

Your market dynamics — local market analysis, one market at a time.

Your systems record every case that presents at your practice. They cannot record the cases treated by a competing group in the same catchment, which practice referred them there, or how long the pattern has persisted. An Alpha Sophia market dynamics report is a one-time local healthcare market analysis addressing both questions: where your cases are being lost, and which relationships warrant investment to recover them.

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Three questions internal reporting cannot answer

Not a reflection of your systems. The data required to answer them sits outside your organisation.

Cases that never arrived

Your schedule records the cases that arrived. It cannot record the patient biopsied four miles away, referred to another provider, and treated by a competitor eight weeks later. That case does not exist within your data at all.

The report establishes: every qualifying case produced within your catchment, and where each was treated.

What share of a referrer you actually hold

You know your principal referrers by name. You do not know whether the forty cases they send represent ninety percent of what they generate or eleven percent. These are materially different positions, and they warrant different responses.

The report establishes: each referrer’s total case volume alongside your capture share, distinguishing a strong relationship from a modest one.

Relationships already in decline

When a referrer begins directing cases elsewhere, your own count frequently holds steady for two or three quarters because their total volume has grown. By the time your figures decline, referral patterns have settled and the conversation is considerably harder.

The report establishes: share trend by referrer, surfacing erosion while it remains reversible.

Most practices hold a working assumption on all three. That assumption is generally formed from who calls, who visits, and who reception recalls — factors that correlate with actual referral volume far less closely than expected. A market dynamics report replaces the assumption with a measurement.

Establish which referral relationships are at risk.Provide your specialty and catchment area, and we will confirm what the analysis would establish before any commitment is made.

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What a local market analysis report is

One market, measured — every practice producing your cases, and where each of those cases actually goes.

A local healthcare market analysis report is a one-time study of a single defined geography that uses medical claims to measure how much of a given procedure or diagnosis happens there, which local practices generate that volume, and where those patients are currently treated. It answers three questions for one market: how big is the demand, who controls the referral, and how much of it reaches you.

Most market research in healthcare stops at population and payer mix. That tells you how many people live nearby. It does not tell you which of the forty practices within twenty-five miles actually produces the cases you want, or that two of them already send ninety percent of their volume to the group across town.

A local healthcare market is not a marketing construct. The Dartmouth Atlas divided the country into 3,436 hospital service areas by assigning each ZIP code to where its residents actually received care — boundaries drawn from patient behaviour rather than from county lines. A catchment behaves the same way, and claims are what let you draw yours.

Claims answer that, because a referral leaves a trail whether or not anyone documented it. The full method is described in our overview of claims-based referral intelligence, and the data underneath it in the healthcare claims data buyer's guide.

Market demand

Annual volume of the procedures and diagnoses that define your market, inside your boundary, with the three-year trend and the rendering sites that produce it.

Referral source map

Every local practice generating qualifying cases, ranked by volume, with the share currently reaching you and the share reaching each named competitor.

Leakage & destination

Where volume goes when it does not come to you — one competitor, several, out of the region, or nowhere at all. Quantified as cases and as share.

Competitive supply

Count and capacity of the providers already serving that demand, so a high-volume market that is already saturated is not mistaken for opportunity.

Liaison target list

The ranked call list: high volume, low capture, sorted by what a single relationship is worth in annual cases. Segmented into build, contest and defend.

Traceable method

Every code, window and boundary written down, so any figure can be traced back, re-run on a new market, or handed straight to a diligence team.

Uncertain whether the claims can address your question?Provide the specialty and the geography and we will confirm what the report could establish, before any commitment.

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Six questions every physician group should be able to answer

Three concerning where cases are being lost, three concerning where relationships should be built. Each with the resulting action and the role accountable for it.

Referral pattern analysis answers questions about the market outside your walls: who generates the cases you want, where those cases go instead, which of your own relationships are eroding, and where demand exists that nobody is serving. Every answer resolves into one action with one owner — a route list, a defence call, a site shortlist, or a diligence flag.

Practices seldom lack a view of their referral market; they lack a measured one. Set out below is each question, what the claims establish, and the action it produces.

Relationships to build

Which practices are generating the cases we want, and in what volume?

Every practice inside your boundary that billed a qualifying case, ranked by annual volume, with the share currently reaching you. Not the referrers reception recalls, and not those in most frequent contact.

Volume cannot be inferred from size or specialty. Peer-reviewed work indexed by NIH on methods for analysing referral patterns found referral rates across five diagnosis cohorts in a single physician association ranged from 1% to 7% — a sevenfold spread among doctors seeing comparable patients in the same market. Two practices of identical size can differ by an order of magnitude in what they actually send out.

Recommended action
  • Set the threshold at which annual case volume no longer justifies a scheduled visit.liaison
  • Reconstruct the visit schedule around the top twenty, ranked by case volume.operations
  • Discontinue standing visits below that threshold — typically a third of the current schedule.growth lead

Cases being lost

Where do these cases go when they are not referred to us?

To a named destination, in counted cases. Volume that leaves is either concentrated on one competitor, dispersed across several, travelling out of the region, or never receiving downstream care at all — and the four look nothing alike as problems.

Concentration is the figure that determines the response. If 70% of a market's lost volume lands at one organisation, there is one competitor and one position to address. If it disperses across eleven destinations with no leader, the constraint is generally access or turnaround rather than preference, and relationship work alone will not resolve it.

Recommended action
  • Identify the three principal destinations and establish their wait times and locations.growth lead
  • Where dispersion is high, review internal scheduling lead times before arranging visits.operations
  • Brief the field on the specific competitor holding each referrer.liaison

Cases being lost

Which referral relationships are at risk of being lost?

The ones whose share of cases sent to you has fallen for three or more consecutive quarters while their total volume held steady. That pattern is a relationship eroding, and it is invisible in your own numbers because your count only drops after the decision has already been made.

This is the highest-return finding in most reports and the one least often sought. Defending existing volume costs a fraction of winning it, and a referrer whose share is declining generally remains reachable for a further quarter or two before the pattern settles.

Recommended action
  • Escalate declining-share accounts to a physician-to-physician conversation rather than a liaison visit.medical director
  • Establish whether a new appointment or additional location at their end accounts for the shift.growth lead
  • Place share trend on the monthly review, ahead of absolute referral count.growth lead

Relationships to build

Is there demand in this market that is currently unserved?

Areas within the catchment where qualifying cases are numerous and the providers serving them are few or absent. This is white space in the literal sense — volume with no incumbent to displace, which presents a materially more favourable position than contesting share.

Two signals point at it. Geographic: a zone with high case volume and no provider within a reasonable drive. Clinical: cases that generate no downstream treatment claim anywhere, meaning the referral pathway does not exist rather than favouring someone else.

Recommended action
  • Shortlist under-served areas for a satellite location, an outreach programme, or a de novo site.executive
  • Approach practices with no downstream claim first — there is no incumbent to displace.liaison
  • Validate against payer mix and staffing capacity before committing capital.CFO

Cases being lost

Are our own physicians directing work outside the group?

Outbound analysis begins with your NPIs and follows those patients forward. Where the subsequent claim falls outside your organisation, that constitutes quantified leakage — by physician, by service line, and by destination.

How much leaves is genuinely unmeasured across the industry. An American Hospital Association session on network retention cited industry estimates putting an average health system's referral leakage somewhere between 55% and 65% — a ten-point range on a foundational metric, which is what happens when almost nobody measures it directly. Replacing that range with your own number is most of the value.

Recommended action
  • Rank internal leakage by service line and address the largest first.operations
  • Distinguish leakage arising from capacity constraints from leakage arising from established practice.growth lead
  • Where a capability is genuinely absent in-network, add it to the recruitment plan.executive

Due diligence

Is this acquisition target's referral base durable, or dependent on a retiring physician?

Concentration and trend answer it. A target drawing 60% of volume from two referrers is a different asset from one drawing evenly across thirty, and a three-year source-level trend shows whether the base is compounding or coasting on relationships that retire with their owner.

This analysis can be conducted before an indication of interest, without the target's participation, because the claims sit outside their systems. It is also the analysis most likely to affect valuation.

Recommended action
  • Calculate referral concentration and flag any figure above the agreed threshold in the IC memorandum.deal team
  • Review principal referrers' tenure and affiliations for succession risk.deal team
  • Model the downside case in which the two principal sources depart post-close.IC

The six questions on one page

QuestionWhat the claims showThe to-do it createsOwner
Who refers to me?Ranked practices by qualifying cases and capture shareRebuild the route list; cut the bottom thirdLiaison
Where does it go instead?Named destinations and concentration of lost volumeCounter one competitor, or fix accessGrowth lead
What am I losing?Referrers with falling share and steady total volumePhysician-to-physician defence callsMedical director
What is unserved?High-case zones with no local provider; cases with no downstream claimSatellite shortlist; approach no-incumbent accounts firstExec / liaison
What am I leaking?Your own patients' next claim landing outside the groupFix the largest leaking service lineOps
Is the target real?Referral concentration and three-year source-level trendConcentration flag and downside case in the IC memoDeal team

Every row ships as its own table in the report, keyed to NPI, so the to-do can be assigned the day it lands.

Which of these six is your question?Advise us and we will scope the report around it rather than around all six.

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Dermatology: where are the Mohs cases being referred?

The most clearly coded referral chain in medicine, and among the least well tracked.

Trace the claim sequence. A skin biopsy billed under CPT 11102–11107 with a malignant skin diagnosis (ICD-10 C44) identifies a case that will need definitive treatment. Whether the next claim is a Mohs stage (17311 or 17313) at your practice, at a competitor, or a wide excision somewhere else tells you exactly where that case went — and the referring practice is the one that billed the biopsy.

The biopsy and the surgery are separate claims, frequently weeks apart and generally at different organisations. No system within your practice observes the second half unless the patient presents to you.

Applied across a market, the volume divides four ways.

Where biopsy-confirmed skin cancer cases go in one marketFigure 2
Where biopsy-confirmed skin cancer cases go in one market 1,240 biopsy-confirmed non-melanoma skin cancer cases in a 25-mile radius split four ways: 318 reach the client's Mohs surgeons, 466 reach two competing Mohs practices, 291 are treated by wide excision locally, and 165 have no definitive treatment claim recorded. Biopsy-confirmed NMSC 1,240 cases / yr · 25-mi radius 318 · Your Mohs surgeons 26% capture — the only slice you can see today 466 · Two competing Mohs practices 38% — concentrated in 9 referring practices 291 · Wide excision, treated locally 23% — never entered a Mohs pathway 165 · No definitive treatment claim 13% — the segment rarely measured
Captured Lost to a named competitor Treated by another modality No downstream claim

Illustrative figures for a single 25-mile radius. Your report carries the real counts for your boundary, your code set, and the competitors named by NPI.

The second-order finding

The significant figure is seldom the competitor's. It is the final two rows. Cases treated by wide excision, and cases with no definitive treatment claim recorded, represent volume that never entered a Mohs pathway — which generally indicates the referring practice has no pathway it relies upon, rather than a preference for another provider's. That is a materially different conversation, and a more straightforward one, than displacing an established relationship.

Some of that excision volume is clinically correct, not lost: the American Academy of Dermatology and the American College of Mohs Surgery publish appropriate use criteria covering 270 clinical scenarios, so a healthy market always shows cases treated another way. The question the split answers is what happens to the rest — and a referring practice with no downstream claim at all is not following criteria, it is missing a pathway.

The same division reframes the target list. A practice directing 90% of its cases to a competitor represents a relationship unlikely to be displaced within the year. A practice directing 60% of its cases nowhere represents a referral pathway that has yet to be established.

SegmentWhat the claims showWhat the liaison does
BuildHigh case volume, little or no downstream Mohs claim anywhereIntroduce the pathway. No incumbent to displace.
ContestHigh case volume, majority to one named competing practiceScheduled visits, with access and turnaround as the argument.
DefendCurrently sends you most cases, share declining across quartersProtect first. The least costly volume you hold.
DeprioritiseLow case volume regardless of where it goesGeneral communications rather than scheduled visits.

The same four-way split applies to any specialty with a coded referral trigger — ortho to physical therapy, cardiology to electrophysiology, GI to surgical oncology.

Background on the terms: physician liaison and patient journey.

The same analysis applies to your specialty.Any service line with a coded referral trigger follows the same method — orthopedics, cardiology, gastroenterology, ophthalmology, ENT, urology.

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Where demand is concentrated within a catchment

A local market heatmap, shaded by demand relative to the supply already serving it.

A healthcare market heatmap shades each cell of a catchment by the volume of qualifying cases it produces divided by the providers already serving it. Dividing by supply is the essential step: a heatmap of raw demand will shade the population centre in every market, which is precisely where competition is already concentrated.

The map below covers one 25-mile catchment for a single service line. Each hexagon is a ZIP-level cell. The scale runs from pale — plenty of local capacity for the cases produced — to deep indigo, where cases per available provider run several times the market average.

Referral demand per available provider — one 25-mile catchmentFigure 3
Local market heatmap: referral demand per available provider A hexagonal-bin map of one 25-mile catchment, each cell shaded by annual qualifying cases divided by the providers already serving that cell. Two dense zones sit in the north-west and south-west of the catchment, roughly seven and nine miles from the client's only clinic. The clinic itself sits in a pale, well-served core alongside two competitor locations, where demand per provider is 31 cases against 214 in the hottest zone. 25-mile catchment · 184 ZIP-level cells Zone 1 — 214 cases per provider 7.4 mi out · 2 providers serving 428 cases Your clinic — 31 per provider sited in the best-served cell in the market Zone 2 — 166 cases per provider 9.1 mi out · nearest provider is a competitor Competitor locations (2) Cases per provider already serving the cell Low High

Illustrative catchment. Cell values are cases per provider already serving that cell — the measure that separates real opportunity from population density.

What a map of this kind establishes

The clinic in this market occupies the palest cell within its own catchment. This is not an oversight — it is the predictable result of selecting a location on visibility, lease terms and drive time, which are the three factors a demand-per-provider surface disregards and the three factors commercial property advisers optimise for.

Three conclusions follow, each requiring a different response:

  • Zone 1 is a satellite question. 214 cases per provider, 7.4 miles out, two providers absorbing 428 cases between them. A capacity gap that will be filled by someone — a build-or-outreach decision for the executive team.
  • Zone 2 is a liaison question. Marginally cooler, but the nearest provider is a competitor, so the volume is addressable through the referring practices rather than through a lease.
  • The clinic's own cell is a cost question. 31 cases per provider with two competitors within a mile. Marketing expenditure directed there purchases share in the most contested part of the market.

Overlaying supply is what separates this from a demographic map. More on the visual side in three ways to use heatmaps to find healthcare targets, and on the underlying method in propensity modelling.

Your catchment mapped on the same basis.Every report includes the heatmap for the boundary you define.

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Read a real report, page by page

A delivered three-page report prepared for an outpatient physical therapy operator assessing nine candidate markets across a five-state footprint. Client and geography anonymised; all other content as delivered.

White space market map · Sample

Clinic Expansion Opportunity Analysis

A demand-versus-supply assessment of nine candidate markets across the five-state footprint, built on current Alpha Sophia procedure and provider data.

Objective

This analysis identifies the markets within the existing footprint where a new joint-venture or de novo clinic is most likely to fill its schedule on opening. White space is defined as a geography in which the volume of surgical procedures that generate downstream physical-therapy referrals is high, while the supply of physical-therapy locations is comparatively low. These markets allow a new clinic to draw on unmet referral demand rather than compete for established relationships.

Methodology

For nine candidate origin points across the footprint, Alpha Sophia’s radius tool defined a 25-mile catchment around each. Two measures were drawn from that radius:

  • Surgical demand — annual volume of the three highest-referral orthopedic surgeries: total knee replacement (CPT 27447), total hip replacement (27130), and arthroscopic rotator-cuff repair (29827), each of which reliably generates an outpatient physical-therapy referral.
  • Physical-therapy supply — the count of physical-therapy sites of care (taxonomy 225100000X) within the same radius.

Surgical demand divided by physical-therapy supply yields a single demand-per-PT-site score. A high score indicates many post-surgical patients relative to available physical-therapy locations — the white space signal. The footprint average is approximately 41.

Market AMarket BMarket C Market DMarket EMarket F Market GMarket HMarket I Footprint average ≈ 41 706551 454338 313020 02040 6080 Surgical demand per PT site (knee + hip + rotator-cuff procedures ÷ PT locations, 25-mi radius)

Figure 1 — Markets ranked by surgical demand per PT site (25-mile radius). Indigo bars exceed the footprint average.

Alpha Sophia · Healthcare Commercial IntelligencePage 1

Market map

Demand, supply, and the white space quadrant

Plotting each market by surgical demand and physical-therapy supply shows where opportunity concentrates. The shaded region represents structural white space: markets producing more than roughly 41 procedures for every competing physical-therapy location. Three markets fall clearly within it — A, B and C — with two more sitting just above the average line. Dense metropolitan markets such as Market I sit at the far right: high demand, but already well served by existing providers.

WHITE SPACE high surgical demand, low PT supply ABC Market I — saturated 16,842 procedures · 843 PT sites · score 20 05k 10k15k 200400 600800 Surgical demand — annual orthopedic procedures (25-mi radius) PT supply — number of physical therapy sites of care (25-mi radius)

Figure 2 — Demand vs. supply. The shaded wedge denotes white space above the footprint average.

Full market ranking
Market (origin)Ortho proceduresPT sitesDemand / siteAssessment
Market A4,3026170.5White space — priority target
Market B7,55011665.1White space — priority target
Market C8,80017251.2White space — strong
Market D4,86610944.6Above average
Market E2,0544842.8Thin demand
Market F5,43814238.3Near average
Market G5,74018531.0Adequately served
Market H3,63212130.0Adequately served
Market I16,84284320.0Saturated — deprioritize

Source: Alpha Sophia, trailing twelve months, 25-mile radius per origin. Procedures = CPT 27447 + 27130 + 29827.

Alpha Sophia · Healthcare Commercial IntelligencePage 2

Priority targets

Recommended markets

1. Market A — highest opportunity score (70.5)

4,302 referral-generating surgeries against 61 physical-therapy sites, with 85 orthopedic surgeons in the catchment. This is the thinnest physical-therapy coverage relative to surgical demand anywhere in the footprint, in a market reachable from existing operations. A new clinic here enters genuine under-supply rather than a crowded field.

2. Market B — high volume, thin supply (65.1)

7,550 surgeries and 118 orthopedic surgeons against 116 physical-therapy sites. Larger absolute demand than Market A with comparable scarcity of physical-therapy access — a strong de novo or joint-venture candidate that also reinforces density between two existing state operations.

3. Market C — deepest referral base (51.2)

The richest referral base of the three: 8,800 surgeries and 208 orthopedic surgeons. Physical-therapy supply (172 sites) exceeds Markets A and B but remains well short of demand. Best suited to a targeted clinic placed near specific high-volume surgeon clusters, which the platform identifies by billing location.

Capabilities applied

Every figure in this report was produced through a single radius workflow, run on current data. The same workflow supports the broader expansion objectives:

  • Site selection — rank any market by procedures-per-PT-site and overlay orthopedic surgeon density, so each new clinic opens near referral supply rather than into an oversaturated field.
  • Provider recruitment — locate therapists by specialty and sub-specialty within a defined radius, supporting hiring in supply-constrained markets.
  • Field team enablement — ranked referral-source lists by specialty and location to direct business-development visits, replacing manual directory research.
Scaling the analysis

This map covers nine origin points. The identical analysis runs for any ZIP code, city, or custom radius across all five states, allowing each joint-venture and de novo decision to begin from referral-backed evidence. The recurring question of whether a location can sustain a new clinic becomes a defensible, quantified input to the site-selection process.

This is a Tier 4 report. Nine markets, one service line, three procedure codes.

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Alpha Sophia · Healthcare Commercial IntelligencePage 3

Anonymised as delivered: client name and market names removed, all figures unchanged. Trailing twelve months, 25-mile radius per origin.

Page 2 merits particular attention. Market I carried nearly four times the surgical volume of the top-ranked market and was the least suitable location, because 843 competing sites had already absorbed that demand. Demand alone would have directed this operator to precisely the wrong market — the failure mode population-based site selection produces consistently.

Your market, in this format.The same structure and the same figures, applied to your specialty and your boundary.

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Example actionable conclusions

The findings a market dynamics report produces — where cases are being lost, which relationships warrant investment, and what acting on each is worth to a physician group or an MSO roll-up.

A market report is worth buying when it changes a decision. These are the six conclusions that most often do: a concentrated referral base you were not working, a site placed in the wrong cell, a pathway that does not exist, an eroding relationship, two of your own sites competing for the same referrers, and a target whose growth belongs to two physicians rather than to the practice.

Each is stated as it appears in a report — a single sentence containing a figure — followed by the decision it informs and the economics that justify acting on it.

Relationships to build

“Two practices generate 38% of the market's qualifying cases and send you 7% of them.”

INTERPRETATION
Your addressable market is far more concentrated than your route list assumes. A liaison covering thirty accounts evenly is spending most of a week on practices that cannot move your numbers.
RECOMMENDED ACTION
Rebuild the route around the two, at weekly cadence, with the medical director on the first visit. Drop the bottom third of the list entirely.

For a physician group: the highest-yield week of liaison time in the year. For an MSO: the same concentration analysis, run across every platform site, identifies which markets justify a dedicated liaison and which should share one.

Market position

“Your newest clinic sits in the best-served cell inside its own catchment.”

INTERPRETATION
The site was chosen on visibility, lease terms, and drive time. Demand per available provider was never in the model, so the clinic opened into the most contested part of its own market.
RECOMMENDED ACTION
The lease cannot be moved. The pattern can be avoided — incorporate demand-per-provider into the site-selection criteria, and address the two under-served areas through outreach rather than marketing expenditure at the existing location.

For a physician group: one avoided de novo error. For an MSO or roll-up: this is the compounding benefit — a site-selection criterion applied across a fifteen-site platform is worth considerably more than any single market report within it.

Relationships to build

“23% of qualifying cases receive no definitive downstream treatment claim anywhere.”

INTERPRETATION
For that slice of the market the referral pathway does not exist. The referring practices are not choosing a competitor; they have no destination they trust, or the handoff fails before it completes.
RECOMMENDED ACTION
Approach those practices first. There is no incumbent relationship to displace, which makes this the least costly volume in the market to secure and the fastest to convert.

For a physician group: same-store growth without taking share from anyone. For an MSO: the clearest organic growth case to present to an investment committee, as it does not depend on winning a contested position.

Cases being lost

“Your largest referrer's share fell from 74% to 51% across four quarters while their total volume held.”

INTERPRETATION
A relationship is eroding and your own numbers have not caught it, because their total volume grew enough to mask the shift. Something changed at their end — a new hire, a new location, an acquisition.
RECOMMENDED ACTION
A physician-to-physician conversation within the month, rather than a liaison visit. Share trend should then be placed on the monthly review ahead of absolute referral count, which is the metric that obscured this.

For a physician group: defending existing volume costs a fraction of winning new volume. For an MSO: referral concentration is a valuation input — an eroding principal source is a revenue-quality issue an acquirer will identify at diligence if it is not identified first.

Cases being lost

“Site A and Site B draw 61% of their referrals from the same nine practices.”

INTERPRETATION
Two locations in the platform are competing for one referral base. Growth at one shows up as decline at the other, and the portfolio reads as flat while both teams report that they are working hard.
RECOMMENDED ACTION
Assign each overlapping practice to a single owning site, and redeploy the released liaison coverage to the markets the overlap analysis identifies as uncovered.

For a physician group: of limited relevance to a single site. For an MSO or physician practice roll-up: this finding exists only at portfolio level — internal cannibalisation between add-on acquisitions is not visible in any single site's reporting, and is a common reason same-store growth stalls following a roll-up.

Due diligence

“The target's top two referrers are both unaffiliated solo physicians nearing retirement age.”

INTERPRETATION
The growth you are underwriting belongs to two people rather than to the practice. If either retires or affiliates elsewhere post-close, a material share of the referral base leaves with them.
RECOMMENDED ACTION
Model the downside case explicitly, structure the earn-out around referral-base retention, and price the concentration risk rather than identifying it in year two.

For a physician group: the same analysis applies before a merger. For PE and corp dev: this can be run before an indication of interest without the target's participation, because the claims sit outside their systems — and it is the analysis most likely to affect valuation.

What each conclusion is worth

ConclusionDecision it changesSingle practiceMSO / roll-up
Referral base is concentratedLiaison route designReallocate one FTE's weekLiaison headcount per market
Site is in a served cellSite selection criteriaAvoid one bad leaseA rule applied to every future de novo
Pathway does not existWhich accounts to approach firstUncontested same-store growthOrganic growth story for the IC
Top referrer erodingEscalation and cadenceDefend cheap volumeRevenue-quality flag before diligence
Sites overlap on sourcesTerritory ownership—Fixes stalled post-close same-store growth
Target concentration riskPrice and deal structurePre-merger checkEarn-out structure and downside case

Illustrative conclusions. Which of these your market produces depends on the market; the report says which apply and which do not.

Which of these would inform a decision you are taking this quarter?That is the finding we scope the report around.

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Who commissions a market dynamics report

Each represents a one-time decision against a deadline, for which a subscription is generally the wrong instrument.

MSOs and management services organizations

Score every market in the platform on one comparable number, so capital and liaison headcount go where unmet referral demand actually is. See how MSOs use provider data for growth.

Physician practice roll-ups

Test whether add-on acquisitions expand the referral base or overlap it. The GAO’s review of physician consolidation describes the roll-up as serial acquisition within a specialty to build share — which only works if the markets genuinely combine. Referral data shows when two add-ons are drawing on the same nine practices.

Private equity and corp dev

Diligence a target's referral base before signing: concentration, source-level trend, and true local share. See our investment sourcing and diligence solution.

Specialty practices adding a location

Rank candidate sites by referral-generating volume already present in the catchment, not by population or traffic count. Pairs with our guide to finding market gaps.

Hospital and health system growth

Quantify outmigration by service line and destination, then hand provider relations a route list instead of a hunch. Definitions in revenue leakage.

Ambulatory surgery centres

Match surgical case volume in a catchment against existing ASC capacity before committing to a build. See the hospitals, ASCs and practices solution.

Operating a multi-site platform?A multi-market report scores every site in your footprint on a single comparable measure and identifies overlap between them.

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From scope to delivery

Four stages. The first is the only one requiring your time.

1. Define the market and the trigger

A short call or a written brief. We require the boundary — radius, ZIP list, county or CBSA — and the codes that define a qualifying case. Where the code set is not established, we propose one for your approval; resolving disagreement at this stage is considerably less costly than at delivery.

2. We fix the scope and the quote in writing

Codes, boundary, time window, named competitors and the agreed components, set out on a single page. Quoted per market rather than per hour. No work commences until it is signed.

3. Analysts run and review the market

Claims are drawn against the agreed scope, the referral sequence is reconstructed, and a second analyst verifies the counts against source before anything is written. Findings that appear anomalous generally reflect a coding assumption, and are raised with you rather than published.

4. You get the report, the data, and a working session

The full report as a PDF, with the provider and organisation tables keyed to NPI, and a walkthrough with whoever has to act on it. If your existing provider lists need reconciling against NPI first, our bulk NPI lookup handles that.

The first stage requires twenty minutes.Provide the specialty and the boundary; we will construct the code set.

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How a report is scoped

Two variables determine the scale of the engagement. Both are agreed in writing before work begins.

Two variables set the size of a report: how much ground it has to cover, and how many codes define a case worth having. No other factor affects it — not your revenue, not your headcount, and not the urgency of the request. What the report contains does not change with scope; only the ground it covers does.

Both are real work. A wider boundary means more providers, more sites, and more destinations to resolve. A deeper code set means more clinical pathways to reconstruct and validate, because each code family needs its own plausible-window logic before the sequence can be trusted.

Variable 1 — market scope

How large a geography the analysis has to resolve, from a single radius around one address up to a multi-market comparison across a platform. Measured by the boundary you define, not by population.

Variable 2 — code-set depth

How many CPT, HCPCS, and ICD-10 codes define a qualifying case. One procedure family is focused; a whole service line with its diagnosis triggers and downstream codes is deep.

The scope grid

The grid below places every combination on a fixed scale of report tiers, so you can see what widening the boundary or adding a code family does to the job before you ask for it. Your quote follows from where you land on the grid.

Market scope Focused1–5 codes · one procedure family Standard6–20 codes · one service line Deep21–75 codes · multi-line
Single catchment
one radius up to 25 mi, or one county		Tier 1Tier 2Tier 3
Metro
one CBSA, or a radius up to 75 mi		Tier 2Tier 3Tier 4
Regional
2–5 markets, or one state		Tier 4Tier 5Tier 6
Multi-region
6–12 markets — MSO and roll-up platforms		Tier 6Tier 7Tier 8

Turnaround scales with tier. Above Tier 8 the work is scoped directly rather than gridded.

What a report can cover

None of the following constitutes a fixed package. These are the components most frequently constructed; which are included in your engagement is determined at scoping, against the question you are seeking to answer.

Referral source ranking

Every practice in the boundary generating qualifying cases, ranked by volume, with your capture share against each.

Destination & leakage

Where the cases go when they do not come to you, by named organisation, in counted cases and share.

Market heatmap

Demand per available provider at cell level, so unmet demand is visible against the supply already serving it.

Liaison segmentation

The market sorted into build, contest, defend and deprioritise, so a route can be rebuilt from it directly.

Erosion flags

Referrers whose share of you is falling while their own volume holds — the relationships still reachable.

Diligence view

Referral concentration and source-level trend on an acquisition target, run without the target’s cooperation.

Multi-market engagements add a comparative ranking across every market in scope. Requirements not listed here are worth raising — where the claims can address them we will confirm so at scoping, and where they cannot we will say so.

What moves a report up a band

  • Adding a second service line. Usually the biggest jump — a full column right, not a half step.
  • Widening past a metro boundary. Crossing into a second CBSA doubles the destination set even if the added area is thinly populated.
  • Naming many competitors. Two or three named organisations sit inside every band. Twenty is a different analysis.
  • Asking for a longer trend window. Three years of source-level trend is standard in the Deep column and scoped separately below it.

Confirm your tier and a fixed quote before committing.Provide the boundary and the code set and we will confirm both in writing.

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Report or platform?

A report is appropriate where there is a single decision and no analyst available. The platform is appropriate where the question recurs monthly. The report is a finished analysis of a defined market delivered by our team; the platform is the tool your team runs against every market, continuously.

One-time reportAlpha Sophia platform
ShapeOne-time deliverableAnnual subscription
Who runs itOur analystsYour team, self-service
ScopeThe markets you nameAny market, any time
OutputA finished report and a walkthroughLive UI, exports, API
RefreshesNo — a dated snapshotYes — rolling data
Bought forA site decision, a diligence deadline, a liaison launchContinuous territory, targeting, and growth work

Plenty of teams start with one report and move to the platform once the second and third markets come up. That is the expected path, not an upsell — see the full set of solutions, or platform pricing.

Where the referral signal comes from

And, just as importantly, what it cannot tell you.

Every report is built on a national, all-payor view of US medical claims covering commercial, Medicare, and Medicaid lives, spanning more than 4 million US healthcare providers. Each encounter carries a rendering provider NPI, a billing organisation, a date, and a code set — which is what makes the ordered sequence reconstructable without access to any single system's EHR.

Claims are the only dataset that sees both sides of a referral, because both sides bill. Registry data such as the CMS NPPES NPI registry tells you who exists and what they call themselves. CMS publishes procedure volumes for the Medicare fee-for-service population in the Medicare Physician & Other Practitioners datasets, which is useful and public but covers one payer and stops short of the pathway. AHRQ’s Healthcare Cost and Utilization Project assembles the largest all-payer ambulatory surgery data in the country, and is the benchmark most procedure-volume research is validated against. Reconstructing who sent whom where, though, requires the ordered sequence across payers.

The academic groundwork is older than the commercial market for it: NIH-indexed research on mapping physician referral networks from administrative claims established that patient-sharing patterns reconstruct real referral structure, and AHRQ's work on care coordination documents why the handoff itself is where volume and continuity are lost. Public benchmarks for how much leaks are wide enough to be unusable at market level — see the American Hospital Association's session on network retention, which puts the industry estimate in a ten-point band.

A figure for your market, rather than an industry benchmark.A market dynamics report replaces the published range with a measurement of your own catchment.

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Frequently asked questions about local market reports

What is a local healthcare market analysis report?

A local healthcare market analysis report - a market dynamics report - is a one-time study of a single defined geography that uses medical claims to measure how much of a given procedure or diagnosis happens there, which local practices generate that volume, and where those patients are currently treated. It answers three questions for one market: how big is the demand, who controls the referral, and how much of it reaches you.

How do MSOs and physician practice roll-ups use a market report?

At portfolio level rather than site level. A multi-market report scores every practice in the platform on one comparable number, which is what allows capital, liaison headcount, and de novo decisions to be allocated across markets rather than argued site by site. It also identifies findings that no single location can observe: overlap between two sites drawing on the same referral base, markets in which the platform has demand but no presence, and add-on targets whose referral base extends the network rather than duplicating it.

How is a market report different from an Alpha Sophia platform subscription?

The platform is a self-service tool your team runs continuously. The report is a finished analysis of a defined market, scoped and delivered by our analysts, with no seat licence and no subscription. A report is commissioned where there is a single decision to be taken - whether to enter a market, whether to appoint a liaison, whether to acquire a practice - and no analyst available to it. Where the report identifies something warranting monthly monitoring, the platform is the natural next step.

What geography can a market dynamics report cover?

Any US geography that can be defined by a boundary or a radius: a ZIP code list, a county, a core-based statistical area, a drive-time ring, or a mile radius around a specific address. Most reports use a radius around a current or planned location, as this reflects how a catchment behaves in practice. Multi-site groups generally request one radius per site so that markets can be ranked against one another.

How do you identify referral sources without access to my EHR?

Referral relationships are reconstructed from the ordered sequence of medical claims rather than from referral orders. When a patient is seen by one provider and then appears at another within a clinically plausible window, both encounters carry dated claims tied to a rendering NPI and a billing organization. Ordering those claims by patient and date reconstructs the pathway across the entire market, including competitors, which no internal EHR can provide.

Can the report show where my referrals are leaking?

This is addressed in both directions. Outbound leakage shows where patients your own providers see are receiving downstream care elsewhere. Inbound loss shows local practices that generate qualifying cases and send few or none of them to you. Each is quantified as a case count and a share, broken out by destination, establishing whether volume is concentrated with a single named competitor or dispersed across several.

What does a physician liaison do with the report?

They work from the ranked target list. Every practice in the market is scored on the volume of qualifying cases it generates and the share of that volume you currently capture, which divides the market into four segments: build, contest, defend and deprioritise. Each row carries NPI, organisation, address and specialty, so a visit schedule can be reconstructed on the day the report is delivered.

Which specialties do you run market reports for?

Any specialty where a procedure or diagnosis code marks the referral. Reports run most often for dermatology and Mohs surgery, orthopedics and physical therapy, cardiology, gastroenterology and endoscopy, ophthalmology, ENT, urology, oncology infusion, behavioural health, and ambulatory surgery centres. Primary-care-to-specialist pathways are well suited to this analysis. Services delivered entirely on a cash-pay basis are not, as they generate no claim.

How is a local market analysis report scoped?

Scope is a function of two things only: the size of the market the report has to cover, and the number of CPT, HCPCS, and ICD-10 codes that define a qualifying case. Those two variables place the job on a published tier grid, and the tier sets the turnaround. No element is billed hourly and no element scales with your revenue. The full scope and the quote are fixed in writing before work begins.

Do I get the underlying provider tables, not just the analysis?

Yes. Every report ships with the full provider-level and organisation-level tables behind each finding, keyed to NPI, so that the ranked lists can be actioned directly rather than re-derived. The methodology appendix states the code set, the boundary and the time window, so any figure in the report can be traced back or re-run.

A question not addressed here?Send it with the specialty and the boundary and we will answer it against your own market.

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Establish where your cases are going — and which relationships to build

Provide the procedure in question and the area you draw from. We will confirm whether the claims can address it, the tier the report falls within, and precisely what it would contain — before any commitment is made.

Schedule a market review › Speak with our team