How important is a Referral Management Solution?
Did you know that currently, only 54% of patient referrals become appointments? If you do the math, patients may not receive the required or desired care 46% of the time. What healthcare providers need to figure out is how many outbound referrals are sent and how many of those convert into appointments. Are the appointments kept? Is payment rendered?
As we have all experienced, rescheduling a doctor’s appointment is rarely a good experience for the patient. What is equally as concerning is the lost revenue that the healthcare practice realizes. This leads us to the leakage issue…revenue leakage in the healthcare industry.
A. Network leakage, shown to represent one-third of patients, takes place when patients under the care of a physician employed by a health system end up receiving care from a competitive provider. Some leakage can be expected based on a lack of clinical specialties, capacity constraints, geographic proximity, narrow network exclusions, or patient preference. Much of it, however, can be prevented with contemporary cloud-based referral and appointment management tools.
- Establish a centralized, accurate provider directory for the whole network that contains detailed areas of clinical expertise.
- Make it easy for providers and staff to search for the right providers for patients’ needs across the network.
- Analyze clinical coverage across your provider network and take steps to fill gaps where needed.
- Enable those referring to view and book into providers’ calendars to remove key pain points in the process.
- Track referral patterns in and out of network and better understand barriers to patient retention.
A referral management system is a unique and powerful tool for health providers to keep track of their patient referrals throughout the care continuum.
Its main goal is to improve and streamline communication among primary care physicians, specialists, and any other health providers involved in a patient’s care.
Want to learn more about ReferralMD’s referral management platform? Click here.
Ultimately, the aim is to improve the overall quality of care being provided by increasing transparency, reducing operational inefficiencies, and enhancing existing processes for healthcare organizations both large and small.
Our industry-leading product, ReferralMD, goes above and beyond by offering real-time communication/messaging, comprehensive marketing tools, competitor analysis reports, and even an e-consult feature that helps to improve patient access.
We also boast the best search engine optimization in the healthcare world, empowering your health system to garner more interest online and attract new patients.
Why Is It Important?
There are a number of reasons why having a referral management system is useful. Healthcare as a whole is highly scrutinized for its high costs and inefficient processes. Referral management software was created as a potential solution to these problems.
In this day and age, healthcare is moving towards maximizing quality and efficiency, while also minimizing cost. The entire industry is adapting to using technology as a means of streamlining administrative operations. This is evident in the widespread adoption of electronic medical record software in hospitals and clinics throughout the nation. The move towards a more unified and structured approach to documentation and caregiving is a step in the right direction.
Let’s take a look at some alarming statistics that indicate the need for such a solution:
- 46% of faxed referrals never result in a scheduled appointment.
- 55% of specialist visits are unnecessary.
- There is $900k of annual leaked revenue per employed physician.
- 50% of referring physicians do not know whether their patients actually see the specialist.
The benefits a referral management solution can provide are widespread and can help to address some of the systemwide problems outlined above.
Benefits:
1. Reduced Leakage
Referral leakage is a huge problem in this country and has contributed to millions in lost revenue for health systems.
Take a look at the graphic below to see just how much is lost annually due to operational leakage.
You can learn more about referral leakage and how your health system can manage it here.
By implementing an effective referral management solution, your health system will see an immediate reduction in referral leakage. As you will find out below, the benefits of a referral management solution are numerous and far reaching, all contributing towards making your health organization more efficient, better equipped to serve patients, and financially prosperous.
Effect: Fewer patients should be leaving your health system for their care, saving millions in lost revenue.
*ReferralMD reduces patient leakage by helping referral coordinators and transition managers identify provider affiliations across entire health networks.
2. Decreased Lead Times
Operational inefficiencies in the medical workplace lead to bottlenecks in the care continuum. Dead time or unnecessarily long lead times are an inconvenience to both patients and providers alike.
Problems will always exist, but investing in a referral management solution can help save time on processes that your health organization can control.
For example, primary care providers (PCPs) frequently refer patients to specialists even when the specialty visit is not likely to be beneficial; studies indicate that up to 65 percent of such referrals are unnecessary. (Source). These unnecessary visits, in turn, lead to long waiting times for those who do need to see a specialist, and these long wait times can result in poor health outcomes.
Although the larger problem of providers needlessly referring to specialists is concerning, having efficient processes and decreased lead times within your health system will help to mitigate these issues. It will also lead to shorter patient waiting times, higher patient satisfaction, and ultimately, more patients being seen.
Effect: Operational efficiency should be at an all-time high, leading to shorter waiting times and more patients being seen.
*Go paperless and save valuable time with ReferralMD’s cloud based application and integrated fax feature. Learn more about our product at https://getreferralmd.com
From Coastal Fertility Specialsts. To read more of what they said about ReferralMD, go to https://getreferralmd.com/coastal-fertility-customer-success/
“Referral MD has allowed us to streamline our process regarding incoming referrals from our providers while also closing the loop for the patients they have referred to us.”
3. Improved Completion Rates
With a referral management system in place, you can track the status of all of your referrals and make sure that your patient is scheduled to be seen in a timely fashion.
With the ReferralMD system, in particular, you are notified when the receiving provider schedules an appointment with your patient. You are also notified when that provider actually sees the patient. This process allows for transparency and improved care alongside the completion of care within the continuum.
ReferralMD – Referrals Dashboard
Both the referring and receiving organizations are able to message each other directly, notify each other in real-time about a patient’s appointment status, and even exchange patient files between offices (e.g., securely transfer labs, x-rays, patient history, clinical notes, etc.).
There are daily task reminders that track the progress of referrals throughout their life cycle and improve care coordination by closing the loop. You can assign tasks to yourself or to other co-workers, giving your health organization structure and accountability.
Effect: Tracking and status updates on all patient referrals will help to ensure timely care and improved completion rates. Also, miscommunication among providers is less likely to happen, minimizing the chances of network leakage.
4. Improved Utilization
Being able to track a patient’s progress through the care continuum helps to improve utilization for both providers and staff. More patients can be seen through the use of online scheduling platforms and widgets. Indeed, it gives patients the power to schedule their appointments based on their availability and the provider’s openings.
PCPs can easily send patients to specialists by searching through directories and evaluating providers based on reviews, quality, and even familiarity.
It’s even better when this whole process can be condensed into one application, allowing both doctors and staff alike to access provider directories.
Take a look at the ReferralMD platform below:
Individual Provider Profile:
Effect: Features such as online scheduling, physician directories, and provider pages embedded within the referral management software can lead to improved utilization for both the provider and the patient.
5. Improved Network Behavior (Identify Competitors’ Referral Patterns)
Most referral management software is focused solely on improving communication among providers and patients. However, a solution that offers network analysis and identifies competitor referral patterns is much more valuable to a health system.
Our product is not only a referral management solution but also a robust marketing and competitive platform. We offer a competitor report feature that allows you to look at all competing providers in your community and see who and where they are sending (or receiving) patients to (from).
Visually analyze your data with beautiful reports and dashboards. Measure real-time operational metrics around referral volume, patient leakage, and competitor referral patterns.
Effect: By having access to competitor referral patterns, providers can better manage their patient network and identify areas of strength and weakness within their competitive market.
6. Enhanced Provider/Health System Communication
A referral management solution is even more important for those providers under a health network umbrella. Many ACOs are built on value-based care models and thus, require an integrated communication solution so that they can maintain the quality of care that is standard to them.
Luckily, ReferralMD uses an open API interface that allows it to integrate with existing EMR technologies. This is important for large health systems that have already invested millions into EHR software but don’t have a referral management solution in place.
ReferralMD’s Patient Access solution gives the entire health network access to real-time patient data, allowing for accurate routing of e-consults and referrals to the most appropriate high-quality, low-cost physician. Our solution streamlines the patient referral workflow process from the moment a patient checks into the time that the appointment is completed.
Large health systems such as UCSF are finding that our platform enhances communication and streamlines processes so that everything is under one roof.
“As a high volume group practice, we receive referrals through a variety of channels. ReferralMD consolidates these channels into a single interface and automates much of the follow-up. Our staff is saving time, and our referring providers are getting better service. It’s a win-win.” – Jake Blackshear, UCSF Department of Oral and Maxillofacial Surgery
Effect: Referral management software that provides in-network communication and timely updates on patient status will allow health systems to become more transparent in their care practices, leading to higher quality metrics and higher patient satisfaction scores.
7. Improved Patient Access
Another added benefit of most referral management solutions is improved patient access. Patients have the power to schedule appointments themselves. They can even use e-consult features to communicate with providers for instances that don’t require in person appointments.
ReferralMD is introducing provider-to-provider curbside e-consults. These are a unique way to provide specialty care consultations for patients who require more than just a phone call (due to charges or necessary documentation review) but not a face-to-face appointment. It is a unique feature that streamline communication between health systems and reduces unnecessary referrals.
Effect: Improved access empowers patients to take control of their healthcare, solidifying patient retention and preventing referral leakage.
8. Additional Patient Time
Finally, and maybe most importantly, referral management solutions save time on administrative processes so that there is more time for what matters most: the actual medical visit.
Effect: Saving time on administrative processes allows for more time for the actual doctor-patient visit.
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