Today, healthcare executives face challenges as they seek to navigate shifting payment models and maintain already narrow margins. The demand to increase revenue while simultaneously cutting costs is not an easy problem to solve. Referral management is one area to which organizations can look for solutions.
In a recent CHIME-Cerner survey, nearly 40% of provider participants indicated they were losing at least 10% of patient revenue to referral leakage1. With one out of three primary care visits resulting in a referral2, improving referral management can help keep revenue in-network and serve as a bridge from fee-for-service (FFS) to value-based care (VBC). However, providers often make referrals based on who they know without taking into consideration supply (provider capacity) and demand (patient needs and preferences), helping contribute to patient leakage. There is an opportunity to address this gap by embracing standardization, creating a data foundation to map consumer needs to provider availability and pivoting from retroactive analysis to real-time decision-making.