Tag Archives: referral management

Five Ways To Reduce Patient Referral Leakage In Hospitals And Health Systems

Hospitals and health systems know that referrals are critical for their business, and failing to manage referrals efficiently can result in loss of revenue. Healthcare providers are losing more than 20% of revenue to patients going out-of-network for care. Most of these hospitals and health systems do not know why and where referral leakage occurs.

It’s only within the past few years healthcare leaders see patient referral leakage as a major issue, and fixing it is their high priority – Missed appointments alone cost the US healthcare system $150 billion annually. Healthcare organizations do not have a solution in place to monitor, track, and report patient referral leakage. They use their electronic health records to monitor and track referral leakage rather than having specific solutions, but healthcare leaders are not happy about how their EHR performs in this particular area.

Today, most hospitals and health systems leverage technology to prevent revenue leakage due to inefficient referral process. Tracking patient referral leakage through a referral solution gives them a complete view of their end-to-end referral process. Technology helps providers enhance care delivery, improve patient outcomes and use of data, and support collaborative workflows.

Here are five ways to reduce patient leakage:

Understand their referral patterns so far:

Organizations should analyze past data to understand their referral patterns. By tracking the right metrics they will not only gain valuable business acumen but also understand how the hospital is performing. Hospitals today use EHR to get this data but it is not streamlined enough to crunch all the data in a logical and meaningful way.

Improve care-coordination:

Effective and efficient communication is crucial in healthcare. Patients need to receive the right level of care from their care providers. It is important to communicate effectively with all who are actively involved in patient care.

Proceed with a data-driven approach:

A data-driven approach will have a sustainable competitive advantage over those who haven’t. The right way to make decisions is by looking at the data. Understand where the leakage is happening and if it is addressable. Health systems/ Hospitals need to use a data-driven approach to guide patient referrals to the best care option available within the network. Such an approach will help meet both the patients’ and hospital needs.

Use prognostic modeling to know the implications of future referral patterns:

Organizations need to understand how fixing referral patterns today may change future referral patterns by using predictive modeling. It’s essential to analyze how these alterations will impact patient flow, care delivery and coordination with referring providers and payers.

Include it as strategic precedence and discuss at the executive level:

Patient leakage more often gets lost among other priorities at the executive level. Organizations need to make patient referral leakage a strategic priority. Top management should drive change and ensure necessary steps are taken to address this challenge.

Tracking and understanding referral patterns will help the large hospitals streamline and manage high- overall performance referral networks, decrease patient leakage and notably impact care quality.

HealthViewX Patient Referral Management Solution smoothens the referral process and solves most operational challenges for Large Enterprise Hospitals. Do you want to know more about HealthViewX HIPAA-compliant Patient Referral Management Solution? Schedule a demo now!

Why do hospitals need a patient referral management solution?

Today, hospitals face numerous challenges in their day-to-day operations. One of the biggest challenges is managing their high-volume inbound and outbound patient referrals. Right from receiving patient referrals through multiple channels like email, fax, phone, etc., this method is often information-intensive and document-driven, requiring greater control and visibility of the entire process.

Patients have difficulty navigating through the referral process, and this experience directly impacts the quality of care. Poor referral management negatively impacts hospitals, and hence clinical staff needs to be careful in processing every referral. An inefficient referral process leads to patient dissatisfaction, patient leakage, loss of revenue, missed appointments/no-show rates, overall operational inefficiencies, etc.

Successful clinical practice depends on effective collaboration and communication among the parties involved in patient care. A solution such as patient referral management for large hospitals has the power to enhance communication beyond the four walls of a healthcare facility. It extends communication to all parties involved in patient care, including the patient. Such solutions can have enormous sway on enhancing the patient experience while driving overall operational efficiency.

Top reasons why hospitals need a patient referral management solution

1. Doesn’t let you miss any referral

Hospitals send and receive high-volume patient referrals through multiple-channels like emails, fax, website form fills, direct messaging, etc. It becomes difficult to track every referral, and there are high chances of missing out on them. An end-to-end patient referral solution will bring all referrals in one single queue and eliminates referral leakage. Referrals from physicians are a key source of revenue for hospitals and they would not want to miss out on them.

2. Engages patients throughout the referral process

Hospitals need to involve patients’ in the referral process. Engaging patients will not only increase process visibility for patients’ but also gives them a clear expectation and visibility into their care transition. Involving patients in the referral process directly impacts the standard of care patients’ receive from the hospital. Overall, engaging patients’ will help reduce referral leakages, improve patient satisfaction, and increase revenue.

3. Referral patterns and metrics/analytics

Referral solutions help hospitals understand their referral patterns and appointment conversion rates. Customized reports and analytics on referrals will help hospitals gain better insight into their business, using analytics such as the metrics dashboard, referral volume, referral patterns leakage rate, wait times, etc. help them with informed decision making.

4. Involves and engages key players for better results

To drive results and for better outcomes, it is crucial to include all the key players’ involved in patient care. Patient referral management solution helps people in different designation achieve their goals at the same time helps provide quality care for their patients. Persona-based reports help each of them in informed decision making.

HealthViewX Patient Referral Management solution helps practices in managing their referral network and increasing their revenue. Are you referral inbound & outbound-heavy practice looking to track all your referrals very effectively? To know about HealthViewX Patient Referral Management System in detail schedule a demo with our team.

How to become a preferred health system for patients and referring physicians?

Healthcare technologies like telehealth, remote patient monitoring, referral management, etc., have simplified the process for health systems to deliver care for their patients. These advancements are uniquely qualified to help health systems attract patients to their facility and build their brand.

So how do you become the preferred health system? What are the strategies behind becoming a preferred health system for your patients, and also for physicians referring patients to your health system?

Care coordination is the responsibility of any system of care and has the potential to transform healthcare delivery, improve the overall effectiveness, and efficiency of any health system. Thus, the key to becoming the preferred health system for patients is to have well-executed care coordination.

For effective care coordination, it is important to connect your entire physician community with specialists and make sure they work in unison to ensure your patients’ health needs are met and the required care is delivered.

If care coordination is done in the right manner, it can improve health outcomes and patient experience along with the growth of the healthcare system. This way, patients, providers, and payers can get benefited. Though there are different definitions for care coordination, in the end all of them point to the same goal which is to become patients’ preferred care provider.

Here are a few tips to become patients’ preferred health system

1. Connecting an entire network of physicians and specialists:

It is important to connect your entire set of physicians and specialists to provide quality care for each and every patient. HealthViewX end-to-end patient referral management connects your entire care network and helps you achieve this with ease.

2. Improve care coordination:

The major priority of all healthcare providers is to achieve care coordination and improve patient care but unfortunately, it still remains a challenge in the industry. The right coordinator may differ from patient to patient. Critical patient information should be readily available for all involved inpatient care. Improved care coordination results in better patient outcomes and patient satisfaction.

3. Effective communication channels and methods:

Software solutions that support upsurge communication and engagement among providers are still lacking. Manual processes (phone call, email, fax, etc.) can lead to fatigue and operational inefficiency. An end-to-end automated solution would help eliminate this challenge. One can improve the quality and continuity of care provided to patients by focusing on improving the transfer of patient information.

4. Gaining the trust of out-of-network providers/physicians:

PCPs prefer hospitals that are easy to work with. It is essential to build and maintain a strong referral base from out-of-network providers/physicians. Hospitals need to work to become a referral partner of choice for physicians and so creating a strong referral base with the referring physicians will pave the way to steady patient inflow. Hospitals should work to encourage out-of-network physicians to become more actively involved in patient care. Lack of communication can lead to poor patient health outcomes.

5. Closing the referral loop:

Planned integration of patient care between providers will help attain better service. As health systems grow more complicated, it is essential to close the referral loop for patient record and safety. The goal of referral loop closure is to track and support patients when they obtain services outside the practice. Closing the referral loop is one of the ways to become a preferred provider.

Health systems need to adopt new healthcare technologies that have the potential to improve patient care and satisfaction. One such technology that health services need to implement is patient referral management. The present referral management is complex, and coordinating care is hard for the health systems. Navigating the healthcare system or care set-ups can be tiring for patients too. Poor coordination can result in reduced quality of care, higher readmission rates, increased no-show rates, referral leakage, and higher cost of care. Better care coordination may result in more satisfied patients.

End-to-end referral tracking and follow-up is a must for effective patient care. Patient Referral Management is one such solution that can solve major challenges faced by health systems in their referral process.

Schedule a demo with HealthViewX Referral Management Solution experts today!

How to build a strong referral network for your medical practice

Health systems and hospitals need to build a high performing and strong referral network as they serve a large community. For most health systems, out-of-network providers/physicians are the main sources for new patients. Hence in today’s highly competitive healthcare market, it is crucial for the health system to build, strengthen and maintain these referral relationships to have a strong referral network.

A strong referral network would need patients, referring physicians and receiving providers to keep a healthy network going. A referral solution has the potential to build a strong referral network.

Here are some reasons as to why you need a solution to build a strong referral network

Health systems need to reduce referral leakage and ensure they don’t refer patients out of their network
Referral coordinators have to ensure timely scheduled appointments for their patients
Health systems need to reduce their no-show rates
Referral coordinators need to coordinate care between the internal and external providers for better patient outcomes.
Hospitals / Health systems need to create and manage a high performing referral network
To obtain more complete and detailed analytics to improve their patient inflow
Track patient status at every stage and ensure referral loop closure

Healthcare providers need to adopt healthcare IT and embrace interoperability. Therefore, the only way to build this strong referral network is to identify and implement the right referral solution for your practice.

HealthViewX Patient referral management solution can bring in the following benefits for the health systems and help strengthen your referral network

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

Making small changes in the way health systems handle referrals will help to retain the patients within the network. Thus, retaining patients within the network, giving quality care will lead to better clinical outcomes. HealthViewX patient referral management solution acts as a bridge and enables seamless communication between the referring provider and the receiving provider. It helps in making meaningful decisions on the referral process thus making the change that the health system requires today.

Staying ahead in healthcare technology is imperative as it will bring massive benefits to the day-to-day operations and can empower the practice as a whole. A more streamlined process can lead to patient satisfaction, happier referral sources and patients thus making the network strong through quality care. Once the entire referral process is fine-tuned providers can fully focus on patient care and relationships with referral sources.

Optimizing referral management will help large health systems and hospitals improve overall efficiency and referral network. Data analytics feature will help providers to understand – the referral patterns, the highest referring source, the lowest referring provider, no-show rates, referral leakage, missed appointments, etc. HealthViewX works with each of its clients to understand their current challenges in the referral system and tunes the referral process to overcome these challenges and build a strong referral network.

HealthViewX patient referral management is highly customizable and is used by leading FQHCs, Large Hospitals, Dental Universities, and Specialities. Do you want to build a strong referral network?

Schedule a demo with HealthViewX referral management solution experts today!

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.