Tag Archives: referral profitability

Revenue lost due to patient leakage in hospitals and health systems

The last few years have been a tumultuous time for hospitals and health systems due to the high patient leakage rate. Even today, patient leakage is a key concern and remains an unsolved challenge in many of the health systems. Health systems are losing more than 20% revenue due to inefficient organizational referral processes, as a result, patients are opting to different care providers for their care needs. Identifying the gaps or latitude to go out of the system, and sealing this, is the basic step that health systems need to take in solving patient leakage challenge.

What are the main causes of patient leakage?

Here are some reasons why patient leakage happens

– Referring physicians refer patients to out-of-network providers

– Patients move out of the care network due to poor care coordination

– Unavailability of a specialist within the care network

Patient Leakage and its consequences

Though in most hospitals patient leakage is contributing to significant revenue loss, this loss is ignored, and not given much importance. Health systems and hospitals need to consider this leakage extremely important. Non-coordinated or fragmented care is one of the main reasons for patient leakage. The point is to emphasize on some damaging consequences patient leakage can bring on care quality and patient health outcomes.

Understanding the actual causes of this leakage and taking tangible steps to address this challenge is vital. It is the responsibility of the health system to track and manage patient referrals in a better way with a solution for tracking leakages and referrals. Otherwise, it can damage the health system’s reputation, undermine its brand value, and even jeopardize its competitive edge.

Challenges in processes that cause patient leakage

Streamlining different processes for different aspects is required for better overall operational efficiency. One such process that needs attention to arrest leakage is the patient referral process. Health systems need to adapt to solutions that will help seal this leakage. HealthViewX helps referral coordinators in health systems to manage patient referral efficiently and improve care, performance, compliance, and reduce leakage.

The current referral process lacks certain mechanisms to make this process effective. Hospitals and health systems need a referral solution in addition to an EMR to solve their referral challenges especially referral leakage.

An ideal referral solution for hospitals should have the following features

Multi-channel referral consolidation

Health systems have multiple access points for patients and chances are that health systems may miss following-up with some referrals. The solution needs to consolidate referrals from multiple sources like fax, email, phone calls, online forms, etc. It should integrate well to bring all of these referrals into one single queue and ensure not a single referral is missed.

Secure exchange of information

A HIPAA compliant solution that supports the secure exchange of sensitive patient information among the care providers involved in patient care is a must. The provider should be able to attach documents securely at any time for one another’s reference.

Patient referral history

Both the referring physician and the receiving provider should have access to the entire referral history. All required information right from the time a referral is initiated and consequent diagnosis reports, referral status, etc. should be available at any point of care.

Scheduler Integration

Patient convenience is one of the most important factors in providing care. Scheduling appointments as per patient convenience and automated reminders for both patient and provider about the appointment is mandatory.

Dashboard and referral insights

The solution has to give complete data of the referrals flowing into the health system. The number of referrals processed, number missed and many more as per the requirement of the health system. These data analytics should give the practice a clear picture of how referrals are handled and where the leakage is happening.

Speak to HealthViewX solution experts to understand more about HealthViewX Referral Solution features that will help solve some of the challenges in the patient referral process and increase revenue through effective tracking. Schedule a demo today!

Transform Your Care Practice With A Streamlined Patient Referral Process

It is imperative to transform your care practice to deliver value-based care. Promoting and exploring technologies for streamlining various processes is the way forward for improved care quality and care coordination. One such process that requires a transformation in care practices is the patient referral process which is still a tedious, fragmented, and time-consuming task for referral coordinators in many health systems. The conventional patient referral process (both inbound and outbound) results in more stress for the referral coordinators and poor patient satisfaction. This inefficiency in the patient referral process leads to frustrated referral coordinators, physicians, specialists, patients and health systems as a whole. Patients not showing up for scheduled appointments are revenue loss for health systems that are trying to keep their patients within the network for better outcomes.

Today’s patient referral process makes it hard for patients to get the care they need, and healthcare facilities the visibility they need in the process. Additional challenges like lack of communication amongst providers, appointment delays, no-show rates, incorrect referral, etc. all have far-reaching consequences. Ineffective communication between clinical teams leads to poor health outcomes of patients and lost revenue for health systems. It is not a surprising fact, that more than half of the PCPs and Specialists are dissatisfied with the information they receive during a referral.

How to eliminate these challenges in the referral process?

A technological referral solution that offers end-to-end automation and is convenient for patients and providers is required to actively manage referrals and improve efficiency.

Healthcare providers need to adapt to an advanced technological solution that

– is patient experience focused, process-driven, and easy to use

– improves PCP, specialist experiences

– has end-to-end referral workflow automation

– intuitive dashboards with data insights and analytics

HealthViewX Patient Referral Management Solution is designed to help providers to focus on delivering high-quality coordinated care by keeping track of their patients throughout the care continuum. The solution makes the referral process efficient and simple with no burden on practice staff. It helps improve patient experience, reduces the burden on staff, improves operational efficiency, and overall benefits the health system in processing referrals.

Streamlining the patient referral process can help with

– better care for individuals and the community as a whole

– lowered cost and improved operational efficiency

– reduced paperwork for referrals

– awareness of in-network and out-of-network providers

– improved patient experience and value-based care drive

– better care coordination among providers

– visibility into real-time data to understand referral patterns, referral staff performance, patient status tracking, and gaps in care.

HealthViewX Patient Referral Management Solution helps solve challenges in all stages of the referral workflow to meet the needs of the patients, healthcare providers, and payers, and also integrates seamlessly with all EMR systems. An intelligent end-to-end automated solution is essential for better provider connectivity, reducing network leakages, improving quality care, and better health outcomes.

Schedule a demo today with our experts to understand how our solution seamlessly solves challenges in the patient referral process.

Referral Management Solution Is The Need Of The Hour For Large Hospitals

With the ever-evolving healthcare setting and exponential developments in health IT, many choices need to be made by hospitals/health systems to provide their patients’ with quality care. Health systems are struggling to manage their clinical, operational and monetary challenges. Most importantly, it is necessary to orchestrate care teams’ workflow movements to be able to demonstrate meaningful use. This is the key to improving patient care and the ability to make better-informed decisions. A lot of providers are already adapting to smarter and new healthcare technologies to shape the future of healthcare.

Factors like sustainability, patient-centricity, care delivery, HIPAA compliance, digital health technology, etc. should be kept in mind before choosing any IT solution. Referral Management Solution is one such solution that is the need of the hour and it has to be chosen with utmost importance. Moving from volume-based to value-based care model will require building a solution to manage higher patient referral volumes, to ensure patients’ receive care within their referral network, track referrals, close referral loops, study dashboards and analytics for meaningful use, etc.

There are a lot of benefits a referral management solution can bring to referring physicians, patients and receiving physicians: that includes, improved operational efficiency, reduced referral leakage, increased referral loop closures, increased revenue and patient satisfaction.

There are several other reasons why a referral management solution is required to manage patient referrals. Hospitals face numerous challenges in their referral process such as operational inefficiency, improper communication among providers, lack of coordination, missed referral loop closures, increased no-show rates, time consumption, etc.

Below are some alarming stats that show the need for a referral solution for hospitals

46% of faxed referrals never result in a scheduled appointment.
55% of specialist visits are unnecessary.
There is an annual leaked income of $900k per physician employed.
50% of referring physicians do not know whether their patients actually see the specialist.

In addition, hospitals participate in passive referral management:

Physician informs the patient about the need to see a specialist.
Referral coordinators may not reach out to the patient to get an update to see if the patient had visited the specialist.
Follow-up or update from the customer is completed only during the next visit.

Active referral management enables both provider and patient-driven processes to be managed by referral coordinators. It ensures maximum efficiency, finds the right provider for the patient, identifies referral patterns, improves stakeholder communication, reduces referral leakage, decreases lead time, improves completion rates, ensures closure of the referral loop and satisfaction of the patient.

Pitfalls in choosing the right Referral Management Solution:

Even though there are different referral management software with an array of features in the market, it often becomes frustrating to choose the right solution for your hospital. So before zeroing in on the solution, a detailed analysis of your current challenges in the patient referral process has to be carried out. Later mapping to the required features of the solution will be the best choice.

Health Systems need an end-to-end interoperable referral solution to track their patient referrals throughout the process until the referral loop closure. The solution should streamline and enable seamless communication among all stakeholders’ involved in-patient care.

Some of the benefits you can see when using patient referral software are

For the providers:

Reduce referral leakage and improved operational efficiency
Seamless communication
Multi-channel integration
Manage and track referrals
Meaningful engagement
Effective diagnosis and treatment

For the patients:

Prompt diagnosis
Save time and money
Better outcome

HealthViewX Referral Management Solution was created with the potential to solve all the challenges faced by enterprise hospitals in their referral process.

HealthViewX Referral Management Solution helps to send and receive referrals securely and seamlessly, provide quick access to patient data, fix appointments, send notifications and alerts, and share information throughout to ensure closure of referral loop. A 30-minute demo with our team will help you know how effective our solution can track and manage the referral life cycle. To know more schedule a demo with us.

Solutions That Help Hospitals To Increase Referral Profitability

Did you know health systems or hospitals lose up to 60% of patients to another hospital due to inefficient referral process?

What Hospitals Need To Do To Increase Referral Profitability?

Today most of the healthcare systems are functioning in silos due to disparate systems that do not communicate with one another effectively. It is a well-understood fact that the current referral process makes it difficult for patients to get the care they need. None of the health systems can afford to lose more than half of their revenue to referral leakage effects. However, with the advent of new healthcare technology, it is possible to improve overall efficiency, increase referral profitability and improve patient outcomes.

Health systems are now pursuing strategies to improve patient flow such as orchestrating the entire referral process. Rethinking patient referral workflow in hospitals is vital to improve patient experience, make operations more effective and increase referral profitability. They are thinking beyond departmental boundaries about the entire journey of the patient in the process, how patient appointments are made and how their clinical information are fetched/ tracked and how the referral loop is closed. It is highly important that they seal referral leakage, reduce no-show rates to increase referral profitability.

Three Major Reasons For Referral Leakages

Poor patient-provider communication:

Effective communication between patient-provider has the potential to enhance patient satisfaction and health outcomes of the patient. On the other hand, poor communication can hamper the relationship and lead to referral leakage.

Lack of Provider-to-Provider Communication:

All providers involved in patient care need to have a better and convenient medium of communication. Referrals through multiple channels can actually lead to poor referral management and cause referral leakage. Providers need to have a secure HIPAA compliant solution.

Complex Workflow:

It is important for the workflow to be smooth and keep track of patients’ right from the time a patient is referred until the referral loop closure.

The one-key solution to increase referral profitability and address all of the above would be to implement an end-to-end referral management solution. Analyzing the referral patterns can help yield more revenue opportunities and increase referral profitability. Understanding patient behavior, communication among physicians, practices, and locations is key in the referral process. Overall, effectively tracking the network should help patients and providers with informed decisions.

Two main attributes that health systems need to look for while choosing a referral solution are

Interoperability for new technology in unexpected ways in integrating with any EMR/EHR

Sustainable design and product features, which can solve the current challenges in the referral process

Product features that health systems need to look for while choosing a referral solution are

Multi-channel Referral Consolidation:

Referrals from various sources need to be brought into a single queue for an easy process of referrals and this can help in avoiding referrals getting missed in the process.

Automated Insurance Pre-authorization:

This process is an arduous time-consuming task and can affect the clinical outcomes of patients, doctors, and specialists. An automated insurance pre-auth can save time and help in processing more referrals.

Finding the right receiving provider within your network:

Many health systems/ large hospitals are joint ventures or acquisitions. Finding the right specialist within the network may be a challenge as PCPs and specialists may not be aware of all the specialists within the network. A feature like this can help find the right provider.

Dashboard and Referral Analytics:

It is difficult to track all referrals that flow in and out of the network. A referral analytics dashboard will help in understanding the referral patterns, a number of referrals and many more data for informed decision making.

Patient Coordination Framework:

A patient-centered care coordination is required for better clinical outcomes and to reduce no-show rates. This feature will help patients, receiving providers and the referring providers are updated through the process until the referral loop closure.

With the above features, hospitals/health systems can expect the below benefits

Reduced patient no-show rates
Reduced referral leakage
Increased operational efficiency
Patient satisfaction
Increased revenue
Streamlined referral life cycle management

And at the same time gain better insight into the business using analytics such as the metrics dashboard, referral volume, referral patterns leakage rate, wait times, etc.

HealthViewX Referral Management is the right choice for large hospitals and health systems to keep track of patient referrals throughout the referral life cycle. Schedule a demo with us to understand the Solution features and benefits in detail and increase referral profitability. Our solution experts will be happy to guide you through our HealthViewX HIPAA compliant Patient Referral Management solution.