An Analysis of Referral Costs and Savings Potential for eConsult Platform Adoption

How eConsults are enhancing network retention and lowering referral costs via effective referral management

Patients are the lifeblood of any thriving healthcare network. Through the use of telehealth clinical services to promote effective referral management, these networks can dramatically enhance vital patient retention, which is key to the success of both fee-for-service (FFS) and value-based care organizations.

Attracting new patients is always beneficial; however, this tends to be resource-intensive. Existing patients typically account for the majority of appointments, making retention a key metric to monitor closely and integrate into organizational goals. When a patient seeks services outside of their established health care network, the network undergoes what is commonly known as “patient leakage,” a generally undesirable result for health systems, patients and payors.

In addition to clear loss of retained patient revenue, this causes difficulties in care coordination laddering up to implications within quality goals for both fee-for-service (FFS) and value-based organizations. Patient leakage is especially undesirable for Accountable Care Organizations (ACO), as these providers still bear the responsibility, financially speaking, for these patients’ outcomes. Patients may pay more out of pocket expenses for out-of-network care, which in turn may negatively impact appropriate follow-up care, outcomes and satisfaction. This begs the following question: how can a healthcare network better approach referral management in a manner that benefits all healthcare stakeholders?