The Valor Consulting Group

Do you know your earned growth rate?

Clinics obsess over new-patient volume. They spend less time asking whether that growth came from people who returned and referred — or from ads, promotions, and a sales push. The income statement cannot tell them apart.

Earned Growth Rate is the neglected metric. Fred Reichheld introduced it beside NPS as an accounting-based loyalty measure. It is the number that shows whether this year’s growth will still be there next year without buying it again.

Two practices can both grow 10%. One earned it. The other bought it. Bain finds that Net Promoter leaders grow, on average, more than twice as fast as their competitors.

Get the Leader Brief Schedule a call

Net Promoter® and NPS® are registered trademarks, and Earned Growth℠ is a service mark, of Bain & Company, Inc., NICE Systems, Inc. and Fred Reichheld. Not affiliated with or endorsed by them.

How to track it without a consultant in the room.

Ask why they came

One required intake question, recorded in the chart. It is the only way to separate earned from bought.

Set the rules once

Physician and patient recommendations are earned. Ads, promotions, and sales outreach are bought. Apply the rule the same way every year.

Pull billing

Revenue by patient. Match IDs across two years for net revenue retention. Total revenue from earned new patients for ENC.

Review quarterly

Rolling twelve months. Put EGR next to total growth in the leadership meeting. The gap is the story.

Pair with the survey

Ask how likely they are to recommend you after discharge. Send comments to clinicians. Never tie scores to bonuses.

2×+

Net Promoter leaders grow, on average, more than twice as fast as their competitors (Bain).

25–85%

Profit gain from cutting customer defections by 5% (Reichheld & Sasser, HBR 1990).

5–25×

How much more it can cost to win a new patient than to keep one (HBR 2014).

The one-pager. Email unlocks it.

Cover of the Earned Growth Rate Leader Brief

PDF

The Earned Growth Brief

The accounting-based loyalty metric Reichheld introduced beside NPS — earned vs bought growth, and why the income statement can’t tell them apart.

What EGR is: NRR + ENC − 100%
Why it matters: two practices can both grow 10%
How to track it: intake question, classification rules, billing pull, quarterly review
Pair with a recommend survey. Never tie it to bonuses.