Why one health system looks like many accounts
Specialty brands increasingly win or lose inside health systems. The prescribing happens in a hospital clinic, the dispense may come from the system's own specialty pharmacy, the infusion is billed under another entity, and the contract is signed at the parent. Account teams are organised around that reality. The data usually is not.
Each source sees a different level of the same organisation. CRM holds the clinic where the rep calls. Specialty pharmacy data credits the dispensing pharmacy and the prescriber's listed address. Claims carry a billing NPI and tax ID. Contracts and 340B records name the parent or the covered entity. Without a hierarchy that links them, one health system appears as a dozen unrelated accounts, and nobody can say with confidence how the brand is doing there.
The consequences show up quickly. Account growth reports move when a system buys a practice, not when patients start. Key account plans miss the clinics that write the most. Health-system pharmacy volume is credited to the pharmacy instead of the system that prescribed. This article sets out why HCO data drifts, what a hierarchy that holds up contains, and how to put one in place. It builds on our guides to survivorship and the golden record and payer hierarchies in pharma.
Four reasons HCO data drifts
Every source sees a different level
The same organisation appears as a clinic in CRM, a pharmacy in dispense data, a billing entity in claims and a parent in contracts. None of them share an account ID.
- Clinic, campus and parent mixed in one field
- Names spelled differently by every source
- Billing entities that match no CRM account
Affiliations change without dates
Health systems acquire practices, clinics rebrand and sites close. When a mapping is overwritten instead of dated, history moves with it, and growth appears or disappears for reasons that have nothing to do with patients.
- Acquisitions read as sales wins
- Last year's account totals restated
- No record of when a link changed
Prescribers work at several sites
A physician may see patients at a hospital clinic, a satellite office and a private practice. Whichever site the rules pick gets the credit, so account totals depend on a rule nobody wrote down.
- Credit follows the most recent address
- Primary affiliation chosen by default
- Field and analytics using different rules
New organisations land unaffiliated
A new clinic or a newly acquired practice arrives in the feeds before anyone links it to its parent. It sits as a standalone account until someone notices it by hand before a business review.
- No alert for unaffiliated sites
- Reference data and CRM disagree
- Manual overrides nobody owns
What an HCO hierarchy that holds up looks like
How to put it in place
Start with your top systems
List the health systems that matter most to the brand and pull every record that could belong to them from CRM, specialty pharmacy, claims and contract data.
Agree the levels and the credit rule
Bring key account management, market access, sales operations and analytics together to agree the hierarchy levels and how prescriber volume is credited across sites, written down with examples.
Link on identifiers first
Match records on organisation NPIs and reference data IDs before names and addresses. Review the uncertain matches with the account teams who know the sites.
Date every link and alert on gaps
Add start and end dates to every affiliation and an alert for new sites with no parent. Report the unaffiliated share by source so it stays visible.
Use it everywhere
Point account plans, call planning, incentive compensation, contract analytics and the executive dashboard at the same hierarchy, so every team reads the same account.
Questions leaders ask about HCO hierarchies
What is an HCO hierarchy in pharma?
Why does our account growth jump when a health system acquires a practice?
Which site should get credit when a prescriber works at several?
Can we rely on our reference data vendor's hierarchy?
How often should the HCO hierarchy be reviewed?
Compare your account data with ours
Pick one health system that matters to your brand and count how many accounts it appears as across your CRM, specialty pharmacy and claims data. We are happy to walk through what a hierarchy would look like for your top systems. More on our work at specialty pharma analytics and automation.
Part of our Pharma Commercial and Patient Analytics hub. Start with our specialty pharmacy analytics.