Umm…Excuse me, you’re leaking.

Referral LeakagePatient referrals are an integral revenue generator for every hospital, clinic and caregiver.  Yet most facilities require the patient to hand-deliver referrals and do not adequately track the originating provider of said referral.  This leads to many issues including reduced coordination of care, loss of revenue, and a poor patient experience. A seemingly routine task during a physician’s day – referring patients to specialists and other care providers – now is being viewed more closely by hospital systems to improve patient management and volume.

Physicians, in many cases, do not consider network affiliation when referring patients to their colleagues.  But network affiliation can have huge implications for both the patient’s quality of care and the hospital system’s bottom line. Hospital organizations need to maintain, capture and improve volumes in order to build revenue and remain competitive. With the advent of Accountable Care Organizations, ensuring patients stay within the network has become even more critical to ensure the ACO’s ability to capture revenue.

Only by tracking referrals can an organization begin to understand and manage patient leakage. Targeted solutions can provide visibility into referral trends and standardize the referral process across the entire network, streamlining operations and communication with physicians.  These industry experts will uncover the importance of provider relationship management and solutions that can be implemented to put the plug in referral leakage.

So why is this happening?

  1. Excessive Specialization Options – over the last 40 years, specialties and sub-specialties for doctors have dramatically increased. Primary care providers have to spend more time learning and managing these groups and stay up-to-date with what types of treatment options are available to their patients.
  2. Referral Rates have increased – Physician referral rates have been steadily increasing, but only 35-45% of referrals for adult inpatient care, as measured by revenue, go to a partner hospital.

So How to Improve Referral Leakage?

  1. Reform your paper-based referral first – many experts suggest embracing electronic referral systems.
  2. Learn how to stand out – Create social media accounts to interact with your patients and showcase your support for the movement toward transparent and value-based healthcare. Perhaps even take a second look at your marketing strategy and redesign if necessary.
  3. Improve the patient experience – while word-of-mouth is important, patient still make decisions based on suggestions from their PCPs.
  4. Improve Physician Education – Educating physicians on who the other ACO providers are and why it is important to refer to in-network physicians is the first part of the equation to limit patient leakage. Additionally, it is important to emphasize that participating providers share in the same quality, experience and cost goals.
  5. Focus on patient education – Once the physicians understand the value of care coordination and who is participating in the ACO, the next step in preventing patient leakage is to educate the patient on how coordinated care will benefit them

When both physicians and patients understand the value of care coordination in an ACO, patient leakage is less likely to occur. Curious to learn more about ACOs? Check out the content contained here.

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Posted on April 6, 2014, in Uncategorized. Bookmark the permalink. Leave a comment.

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