Referral Leakage: Let’s fix it together

The Case

You’ve spent years building up your reputation as a physician. Entire families have been coming to see you for nearly as long as you’ve been practicing medicine, and they consider you an invaluable resource for their wellbeing. One day, a patient you’ve been seeing for years comes in for an appointment, explaining that they have recently developed chronic back pain. After trying a variety of tests and treatments over the course of a few months, nothing seems to be doing the trick. So, you decide that it’s finally time to refer them to a specialist. You send a referral to a local neurosurgeon—and wait. You hope for the best but have no visibility into whether the specialist received the referral, whether your patient saw the specialist, or—most importantly—whether your patient is still suffering from their chronic pain.

What is Referral Leakage? 

If this scenario sounds familiar to you, then you have probably experienced the dangers and frustrations of referral leakage firsthand. Basically, when a patient seeks care from, or is referred to, a healthcare provider outside their practice, the referral is prone to be lost up be 50% of the time on the first go around. It slips through the cracks, alongside your patient’s hope for a quick evaluation. The referral you sent to the neurosurgeon, for example, may likely have gotten lost during the transfer of care. To fully grasp the enormity of the issue, one must understand the primary negative effects of referral leakage, why it occurs in the first place, and recommendations to prevent it.

The Cost

For many healthcare professionals, the amount of referrals that vanish is a mystery (and a frustrating one, at that). It’s estimated that the average hospital loses a staggering $200–$500 million a year to disappearing referrals. Not only is referral leakage a vexing, time-consuming problem for the primary care physicians trying to establish a care plan for their patients, but it can also be a loss of revenue for the specialists, ancillary care providers and hospital networks. Seeking out-of-network care can complicate previously agreed upon payment plans and discounts between all parties, meaning higher overall costs for payers. Between the harm leakage causes in terms of costs, relationships, and care management, 94% of medical professionals surveyed in the “Patient Leakage & Keepage Report” agreed that decreasing leakage should be a 2022 priority.

The Why

So, with a systemic problem as commonplace as this, and with most medical professionals in consensus about fixing it, why does it persist? Well, to fix a problem, we must first understand why it happens. One of the most significant reasons referral leakage occurs is that many medical offices continue to use outdated communication systems like fax and eFax to transfer referrals. Although these technologies were the workforces of medical offices for many years, they are less secure than assured, cloud-based programs and are not trackable. The “confirmed” message received after sending a fax or eFax only confirms that it was sent. It gives no information about whether the message went to the intended destination, no acknowledgement of receipt, and most importantly it does not tell you if your patient was contacted or scheduled for a consultation. The problem is further complicated by lack of efficient and timely communication between practices, the physician’s lack of knowledge about available specialists in their network, and sometimes poor patient engagement in the referral process. It is clear that there are many cracks in the current referral process.

Zero Leakage Guaranteed

Yes, MedMatch Network automated referral work-flow guarantees zero leakage. With nearly all providers using electronic health records (EHR) systems, it makes sense to make secure and reliable electronic referrals. It is time to ditch the fax and its cousin the efax.

The How

MedMatch Network is a cloud-based platform with seamless integration with most major EHR systems. With the ability to digitally track referrals, MedMatch grants you visibility into whether a specialist receives your referral, as well as when your patient sees that specialist. It also allows you to communicate directly with other physicians and specialists about your patient’s care, regardless of network. With all providers connected on the same cloud-based technology, there is no room for leakage between providers and specialists. With additional features, such as direct messaging and peer reviews, the network ensures the best continuity of care for your patients.

Your Practice Reimagined

Let’s return to your story. As a renowned community physician, you choose to integrate MedMatch Network into your EHR system to ensure that no patient slips through the cracks. In the absence of referral leakage, your already successful practice is able to generate even more revenue and satisfaction for your patients, front office employees, and partners. You are grateful to the network for providing a system that saves time and money so that you can return your focus to the families and patients you serve.

Dr. Amos Dare

Dr. Amos Dare

Dr. Amos Dare is the Founder and CEO of MedMatch Network, Inc. Dr. Dare is a Yale school of Medicine trained, physician and neurosurgeon with over 22 years experience in the practice of private and academic medicine.