Building a referral management approach patients deserve

Stephanie Diaz
March 30, 2021

A sneak peek at our latest referral management resource

High-quality provider referrals are at the heart of every patient’s journey along the care continuum. Each year, more than a third of patients will need referrals to a specialist or alternate care setting, putting enormous pressure on other providers and digital health solutions to get it right. Yet, referral management processes are often disjointed, and rapid and frequent provider data changes are to blame.

Poor provider data derails transitions between care settings

The problem is shockingly widespread. Studies have found that the contact information in provider directories is incredibly inaccurate across Medicare Advantage and commercial markets: the rate of incorrect provider addresses is as high as 35 percent, while up to 48 percent of phone numbers are inaccurate. Even when a provider appears in the same payer network across markets, approximately 30 percent of their data is inconsistent from directory to directory.

Both referring providers and specialists are dissatisfied with digging for up-to-date information to ensure that patients can connect with the professionals they are supposed to see. Close to two-thirds of providers and 35 percent of specialists agree that the referral management process needs to change.

Patients also suffer in this situation. One-third will fail to follow up on a referral, putting them in danger of deteriorating health and higher long-term expenses on preventable care. The problems with referral management are significant, but the solutions are within reach.  

A better patient experience, guided by data

By bridging the gaps between provider data silos and incorporating provider performance data into the referral process, providers and digital health solutions are a step closer to ensuring that patients receive convenient, high-quality, and cost-effective care.

Download our latest resource, Building a Referral Management Approach Patients Deserve, to learn more about provider data barriers in referral management and its impact on the patient care journey.

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