No business wants to lose a customer, and no healthcare provider wants to lose a patient. It’s bad for business, and it may very well be bad for your patients’ wellbeing. But what does losing a single patient really cost a rehab therapy practice—especially if that patient had gone on to be a loyal one? (Hint: It’s more than you might expect.) Read on to learn how to calculate the cost of losing a patient in your clinic—and what patient retention strategies you can implement to prevent patients from disappearing in the first place.

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Your patients are valuable—but, just how valuable?

According to Strive Labs co-founder Ryan Klepps—the author of this blog post—the best way to assess the dollar value of each patient is to use the patient lifetime value (LTV) metric, which is the product of two variables: price and customer retention. While there are numerous ways to calculate LTV (as demonstrated by this Kissmetrics infographic), to get a rough idea of “the projected revenue that a customer will generate in [his or her] lifetime,” multiply the amount you charge for a session by the average number of sessions you provide to each customer.

LTV = the price of your service X the number of services your customers buy

Here’s an example:

To illustrate this metric, Klepps uses Netflix as an example: Let’s say Joe’s Netflix subscription costs $10 a month and he uses the service for 10 months before canceling it. Joe’s lifetime value as far as Netflix is concerned is $100. Simple, right? But, instead of waiting until Joe cancels his membership to calculate his LTV, Netflix averages the LTV of all of its customers by factoring in the average cost of its services and the average length of time customers stay on board. Considering how popular Netflix is, it’s likely that the lifetime value of an average Netflix customer is actually higher than Joe’s. In fact, according to this blog post, customers usually stay with Netflix for 25 months (and the monthly price is closer to $11.65). Once you’ve calculated the average lifetime value of a customer (the average price of your sessions multiplied by the number of sessions you provide each customer), you’ll know exactly how much a lost patient costs your practice.

There’s also the loyalty factor.

Of course, you must also account for the loyalty factor. While this may not be quantifiable in terms of a dollar amount, losing a patient that you could have turned into a loyal customer costs much more than your LTV calculation may indicate. That’s because you have to factor in the lost value of not only that one patient’s services, but also the services you may have sold based on his or her referrals. If you’re tracking your NPS®—and using patient feedback to increase the number of Promoters in your practice—then you may already be familiar with how easy it is to get your loyal patients to serve as brand evangelists by singing your praises on online review sites and to family and friends. This type of word-of-mouth referral marketing is practically invaluable—especially as more patients are doing their own research prior to making decisions about their care. Plus, loyal patients are significantly more likely to retain your services again in the future or try a new offering, which means letting them go—or not doing the work necessary to turn dissatisfied patients into satisfied ones—could hurt potential future revenue even more.

The structure of your practice impacts your options.

In order to increase its LTV, Netflix could increase the cost of its services, boost its value proposition to keep customers engaged with its services longer, or do both. If you’re a cash-based or out-of-network rehab therapist, then you have the same options as Netflix does when it comes to increasing your LTV. If you rely on third-party reimbursements, however, then you probably don’t have the option of increasing the cost of your services. Instead, the only way to improve the LTV of your patients is by increasing your value proposition to retain your patients longer. And according to Klepps, “the only surefire way to retain a customer is to provide a service that provides the customer with sustained value.”

Rehab therapists have an LTV cap.

Unlike other healthcare providers who only see patients sporadically—for example, at an annual checkup, in an emergency situation, or to perform surgery—rehab therapists can only stay in business if their patients return on a regular basis. Thus, according to Klepps, the only real difference—in terms of LTV—between a rehab therapy practice and any other subscription-based business is that rehab therapy has an LTV cap. While other businesses could theoretically retain a customer forever, rehab therapists have a “maximum care duration that is dictated by either the amount of visits approved by insurance or an improvement in the patient’s functional ability where therapy is no longer needed.” That being said, unless all of your patients are completing their course of care in full, there are things you can do to improve retention.

Patient retention deserves special attention.

According to the same Kissmetrics infographic, “Research has found that a 5% increase in customer retention can increase profits by 25% to 95%.” In case that wasn’t enough motivation for you to give customer retention some special attention, consider this: “it costs six to seven times more to gain a new customer than keep an existing one.” Before you can improve your retention, though, you should take a baseline measurement by calculating your patient retention rate (PRR), which is simply the percentage of expected sessions your patients actually attend.

PRR = the average number of session your patients attend / the average number of sessions you recommend (or insurance authorizes)

For example, if, on average, you recommend (and/or insurance authorizes) 10 sessions per patient, but your patients leave after, say, seven, then your PRR is 70%—and that’s essentially costing you 30% of your revenue potential.

Improve the patient experience—and you’ll see your patient retention rate improve.

While there’s no way to prevent every patient from bailing on therapy early, there are plenty of things you can do to improve the patient experience, thereby reducing the number who do—and improving your patient retention rate. For example, you could:

  • Set clear expectations at the onset of care about the impact that patient participation and engagement has on patient outcomes.
  • Get your entire staff involved in the process.
  • Uncover your patients’ real motivation to feel better, and explain how the work that you do together ties into that.
  • Send automatic appointment reminders to help patients remember their appointments.
  • Collect patient reported outcome measures (PROMs)—and use that data to keep patients excited about their progress.
  • Provide access to an interactive patient portal with a comprehensive home exercise program that gets patients excited about completing their homework—and makes it easy for them to do so.
  • Collect—and act upon—patient feedback in a consistent and timely manner to help you improve the patient experience.
  • Increase the value of your sessions—and the appeal of your clinic environment—by offering something unique.
  • Use outcomes data to benchmark the success of your clinical programs and make adjustments as needed.
  • Touch base with your patients outside of the clinic at regular intervals to check on their progress and commemorate milestones.
  • Provide valuable content and educational resources to empower your patients to take the reins on their health.

Patient engagement software can help.

While you could certainly work to improve your LTV and your patient retention manually, if you’re running a large practice—or simply looking to scale a growing one—you may want to explore patient engagement software designed specifically to help rehab therapists keep their patients engaged in their care. To that end, Strive Labs is the complete patient relationship management platform for rehab therapy, enabling providers to design and implement patient engagement, retention, reactivation, and referral campaigns to grow their practices. Still not sure if Strive Labs is for you? Clinics using the platform have been able to decrease early patient dropout by up to 20% and increase patient referrals by more than 5%, all while reducing work for clinical and administrative staff. Click here to schedule your complimentary tour of the software.


Losing a single patient can cost your clinic more than you would expect, and losing lots of them can be hard to recover from. How do you manage patient retention in your clinic? We’d love to hear about the strategies you’ve successfully implemented in the comment section below. 

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