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Accurate Information Using ReferralMD Provider SmartMATCH Reduces Leakage

Fundamentally, referral leakage is failure to be perceived as the best provider in a competitive market.

Guide Referrals to Highest Value In-Network Providers

Research and match patients with the most appropriate affiliated in-network doctor based on a number of criteria, and transfer the patient with streamlined workflows and tracking capabilities.

The True Cost of Patient Leakage

  • More than 200,000 physicians in the U.S. are now employees, and 3 in 4 medical residents will start their career as employees of a medical group, hospital or faculty. As healthcare organizations continue to consolidate and build larger networks, better collaboration between primary care and specialists is critical.
  • With only 35% to 45% of referrals for adult inpatient care, as measured by revenue, go to a partner hospital. This results in over $90M dollars in revenue lost for every 100 employed physicians due to care teams not having accurate information about their specialty care network.

 

When patients receive out-of-network care:

  • The ability to coordinate care is dramatically decreased, which in turn can undermine patient outcomes and population health management efforts.
  • The network loses both clinical and financial control of the patient’s care. For example, an out-of-network physician may order tests and treatments that do not align with evidence-based best practices. Regardless, the parent network is still responsible for the cost. In this case, patient leakage can significantly increase the cost of care.

Features:

  • Improve the specialty care selection process with accurate network affiliation, insurance accepted, proximity to patient, specialty, sub-specialty, procedures and conditions treated (and more)
  • Optimized referral workflows based on your health systems specific requirements
  • Tag providers as either affiliated (in-network) or non-affiliated (out-of-network)
  • Provide PCP communication tools and access with your facility

Benefits:

  • Improve patient wait times and access to care
  • Improve referral volume/rates, preparedness, and appropriateness
  • Fewer out-of-network referrals
  • Increase revenues for fee-for-service organizations and lower risks and costs for value-based care organizations
  • Higher physician satisfaction and engagement