Millions of U.S. patients are referred for specialized services each year, but as many as 45 percent will never make it to the referred-to clinic or hospital.
At a time when health systems are focusing on big-ticket cuts, a few missed appointments may not seem like much to get excited about. But, the cumulative effects to the bottom line can be staggering: Health systems lose 55 to 65 percent of revenue as a result of referral leakage, or a collective $150 billion a year. Calculated on a per-provider basis, health systems are estimated to be losing nearly $1 million per year, per affiliated physician.
Where are those referrals going? Certainly, symptoms sometimes clear up and patients decide on their own that they don’t need further treatment. The majority, however, will slip through the system as a result of some degree of poor communication. It’s estimated that half of referring and specialist physicians do not communicate with each other at all, and 25 to 50 percent of referring providers never circle back to find out if their patients actually saw the specialist.
That puts the patient in the precarious position of coordinating his own care. If he’s not clear exactly why a specialist visit is necessary, or if he has difficulty scheduling an appointment with a specialist who is not expecting his call, or if he has a frustrating experience because the specialist has not been updated on his condition, he’ll self-refer out of network or even ignore the referral altogether.
An effective referral communication plan can increase follow-through and keep patients in-network. Here’s what we recommend:
Managing referrals is one way to improve profitability in your health system. Download the Revenue Rescue eBook to learn more.