Structural and executional drivers of downstream revenue

Revenue flows that occur at other related organizational units and over time are an important part of customer profitability analysis and resource planning. This study analyzes downstream revenue generated from establishing a series of additional organizational units. The setting is a central hospital which established a group of specialty outreach clinics. Using a specially-collected time-series database I show two distinct patterns, depending on the clinic's specialty. One type triggers immediate incremental downstream revenue to the clinic's sponsoring department. The other type of clinic generates revenue that is smaller in value, later in time and mostly in departments not associated with the sponsoring department's medical specialty. Structural and executional clinic characteristics such as distance and clinic frequency differentially affect the amount of revenue generated, implying a need for tailoring performance measures to “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.