Understanding Leading vs. Lagging Measures in Healthcare: Why the Right Metrics Drive Transformation

In healthcare, success depends on measuring the right things at the right time. Too often, organizations rely heavily on lagging measures—values that show what has happened. Instead, we should focus on leading measures—values that can predict future performance. At TriStar Business Intelligence, we believe that shifting focus to leading measures can transform how clinics and healthcare companies operate, improving outcomes for both patients and practices.

Understanding Lagging Measures

Lagging measures track past performance. It’s like a report card from school; they summarize our performance over a period of time. While they are valuable for understanding outcomes, they do little to guide daily decision-making. Common examples in healthcare include:

• Patient satisfaction scores (reported after visits)

• Financial performance (monthly revenue, profit margins, cost overruns)

• Clinical outcomes (readmission rates, complication rates, mortality rates)

  
  

These metrics are important, but like a report card, by the time they are reported, it’s too late to change the results. They answer the question: “Did we succeed?”

Understanding Leading Measures

Leading measures are predictive; they show whether an organization is on track to achieve its goals. They are actionable, easier to influence in real-time, and highly valuable for proactive management. Using our school analogy, these are like homework grades. We can regularly assess how we are doing and make changes before the test. If you don’t understand the homework, will you succeed on the test? In healthcare, examples of leading measures include:

• Appointment scheduling metrics (average wait times, % of open slots filled)

• Preventive care engagement (flu shots, screenings, wellness check attendance)

• Staff performance indicators (time-to-chart-close, patient follow-up calls completed)

• Referral follow-through (patients completing recommended specialist visits)

  
  

Leading measures answer: “Are we doing the right things today to ensure success tomorrow?”

Why This Distinction Matters in Healthcare

Healthcare organizations that rely only on lagging measures often react too late. For example:

• A clinic discovers declining patient satisfaction after dozens of patients leave for competitors.

• A hospital identifies revenue shortfalls only after the quarter ends, missing opportunities to adjust staffing or billing efficiency.

  
  

By contrast, leading measures allow leaders to course-correct before problems grow. Examples include:

• Tracking provider availability, follow-up care, or denied claims in real-time can prevent poor outcomes, financial losses, and patient dissatisfaction.

• Daily open/unsigned chart rates that result in denials due to late claims.

  
  

How Business Intelligence Helps

Business Intelligence (BI) tools bridge the gap by making leading measures visible, trackable, and actionable. With the right BI dashboards, healthcare leaders can:

1. Visualize Real-Time Metrics: BI platforms pull data from scheduling systems, EHRs, and billing platforms to display up-to-the-minute trends in patient flow, claims status, and care delivery.

   
   

2. Spot Patterns Early: Dashboards focusing on leading measures highlight trends—such as rising no-show rates—before they impact revenue and outcomes.

   
   

3. Drive Accountability: By assigning ownership of leading measures (e.g., Clinicians will ensure 90% of charts are signed by the end of the day and no charts are left unsigned after 5 days), BI empowers staff to take proactive steps toward improvement.

   
   

4. Transform Culture: Focusing on predictive, actionable data builds a culture of continuous improvement, where staff aren’t just reacting to results—they’re actively shaping them. By identifying leading measures and setting clear goals, you empower staff to grow your practice!

   
   

Example: Getting From Lagging to Leading

Business Challenge: Clinic revenues are down 15% in the 2nd Quarter 2025 compared to 2024.

In this example, we see a practice suffering a reduction in revenue. It is using a lagging measure, revenue, to track success. This lagging measure shows the result, but not the root problem. When analyzing the clinic’s data and processes, we learn that the volume of patient appointments was also down by 20% compared to the year prior.

At first glance, it may seem that measuring the volume of appointments might be a good leading measure. However, the key to choosing a good leading measure is your ability to influence it in real-time. A deeper look into the data uncovered that most patients left the practice without scheduling follow-up appointments. Additionally, many patients in their panel needed a follow-up appointment and it was never scheduled. They discovered that when a patient scheduled their follow-up appointments as part of the check-out process, they were more likely to get their follow-up care on schedule. Those who were not scheduled at check-out were more likely to miss their appointment window.

Now we have the basis for an impactful leading measure: the percentage of patients leaving the practice with a scheduled follow-up appointment. By creating a clear expectation that the check-out staff schedule a follow-up appointment at discharge, they can drive the success of the patient’s care and the well-being of the practice. This is just an example of how one small change in practice can impact your overall goals. Revenue is driven by multiple factors, and TriStar BI can help you identify which ones significantly drive your revenues and help you achieve your goals.

Lagging Measure: Revenues by Quarter

Leading Measure: % of patients leaving without a scheduled follow-up appointment at the day of service.

Conclusion: Measure What Matters

For healthcare organizations, the path to transformation lies in measuring the right leading indicators—not just waiting on lagging results. With TriStar Business Intelligence, practices can unlock the power of real-time analytics, identify actionable insights, and ultimately deliver smarter care and stronger performance. Your future success depends on the measures you track today. Schedule your free consult today and sign up for our monthly newsletter.

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