Is your health system ready for the post-pandemic referral wave? Most health systems aren’t.

Team Innovaccer
Thu 22 April 2021

The COVID-19 pandemic has had a far-reaching impact across the entire U.S. healthcare system, including the creation of a massive care backlog stemming from thousands of procedures that were canceled due to the crisis. This backlog is expected to create the largest volume of referrals that our system has seen and will increase the risk of patient leakage as patients evaluate various options for elective surgeries and other post-pandemic care. The situation creates a huge opportunity and/or threat for health systems in risk-based contracts depending on their preparedness. In a recent Innovaccer survey, more than half (53%) of healthcare executives were concerned about the pending surge of referrals

Few healthcare organizations are prepared for the coming referral spike — and most stand to lose millions of dollars

Despite their concern, less than half of executives (41%) reported that their organizations are fully prepared to manage this expected surge of patient referrals. Without the proper strategy, systems, and processes in place, health systems with value-based contracts are likely to see significant patient leakage that creates a host of downstream challenges, including: 

  • Lost revenue: 81% of survey respondents expect patient leakage to cause revenue loss

  • Inability to track care: 48% expect a negative impact on their ability to track care

  • Lack of  control over care costs: 45% expect a negative impact on their ability to control costs 

  • Lack of control over care quality: 38% expect a negative impact on their ability to control quality 

Patient leakage threatens risk-based contracts as well as traditional fee-for-service (FFS) models. More than 79% of survey respondents were concerned about the impacts of patient leakage on their traditional FFS business, and 29% of respondents were concerned about pandemic-related leakage on the value-based care side of their operation. And according to a study from Sage Research Partners, more than 40% of healthcare executives reported losing more than 10% of their total revenue to patient leakage, translating to hundreds of millions of dollars in annual losses. 

Avoiding losses with a comprehensive referral management solution

Most referral challenges and losses due to patient leakage are avoidable. Innovaccer’s recent survey asked healthcare executives, “Which solutions do you believe would best help your organization reduce patient leakage and manage referrals resulting from COVID-19-related procedure cancellations and delays?” Sixty-two percent of respondents indicated that referral data analytics and reporting would be useful, while others indicated point-of-care referral scheduling (48%) and provider intelligence (36%) would provide the support they need. Executives recognize the importance of 360-degree visibility of referral systems and processes, deep insights on network provider performance, and the ability to schedule referrals at the point of care.

Keep patients in-network and on track with Innovaccer’s Referral Management solution

Innovaccer’s new Referral Management solution is designed to help providers reduce network leakage with streamlined workflows and industry-leading analytics. Powered by the Innovaccer Health Cloud, the comprehensive suite of robust tools provides advanced scheduling functionality and facilitates the safe exchange of patient health information between providers. With Innovaccer’s Referral Management solution, providers can optimize referral processes with real-time booking and appointment confirmations, create lists of preferred specialists based on core metrics, and analyze patient data to quickly close care gaps and ensure patients stay within the network to achieve better health outcomes.

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