There are five ways our eConsults support the transition to value-based care and help manage referrals. A primary care physician, a nurse practitioner, or a physician assistant can submit an electronic request for consultation to our team of specialists to minimize face-to-face specialty visits and manage referrals. As a result, eConsults beautifully complements telehealth and expands the scope of services available at primary care practices and clinics.
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Leverage a physician referral service to capture revenue
More and more practices are looking to a physician referral service to improve the referral process and capture more revenue. A study of 105 million referrals by the Archives of Internal Medicine found that only about half of referrals resulted in a visit to a specialist. This means roughly 50% of the time, patients fail to receive the care they need, and specialists do not capture the most revenue.
AristaMD’s physician referral service streamlines the referral process for patients, specialists, and their referral partners. By automating the primary care to the specialist referral process, practices can expect an increase in referral volume and revenue.
There are several reasons the patient referral and follow-up process is complex. Determining which specialists work with a patient’s insurance and considering patient preferences around location and availability is a manual, time-consuming process for most practices. One study showed that less than 50% of adult inpatient care remained within a health system, leading to network leakage, while another study found one-third of patients are lost. While some leakage is expected due to lack of clinical specialties, location, patient preference, capacity restrictions or network availability, most network leakage can be avoided by using an online referral system.
The revenue impact of a poorly managed referral system can be quite significant. In a 2015 survey of 140 hospital CFOs by the American Physical Therapy Association, 51% said they were focusing on leakage as an opportunity to generate revenue. For physician networks, the revenue impact is equally noteworthy. For example, a 500-physician network can miss nearly $100 million in annual revenue due to leakage, according to The Annals of Internal Medicine and The Advisory Board. Primary care providers may send $50 million in referral-related revenue outside the system, and another $40 million worth of referrals go unscheduled.