By some estimates, 55%-65% of an average health system’s referrals between primary care physicians and specialists go out of network. Whether self-directed or provider-referred, when patients receive healthcare services outside the network, the following may occur:
- Patients lose care continuity, leading to a frustrating experience and suboptimal outcomes.
- The health system loses visibility of the full episode, unable to track progress or plan future care.
- The out-of-network specialist lacks access to records needed for proper treatment.
- Referrals may be denied, diagnosis and care delayed, and testing duplicated.
- The originating health system loses revenue (assuming it had capacity in-network).
Ultimately, you want trustworthy data to help turn leakage risks into effectively-managed referrals. Healthcare analytics can show primary care providers and specialists where they can improve referrals and reduce out-of-network leakage.
Download this whitepaper to learn how leading health systems, Banner Health and Rush Health, use data to retain patients in their network and improve care quality.
