Referral Leakage: Do You Know Your Drivers & Barriers to Growth?

Do you have 1 or more outreach champions? (i.e. a reputable physician or other internal partner)

Do you also have a new provider joining the market with a specialized offering and/or increased patients?

If yes, engage these individuals in your provider outreach efforts in a way that builds rapport and trust.

Does your team have the “best” stats?

Being the “best” is easy to say. But being able to back it up with outcomes, whether it is with your HCAHPS scores or specific quality measures, is more impactful. Take the time to plan the best format for showcasing these metrics to interested partners.

What other internal or external data do you have to help you strategize?

If you have timely and reliable access to internal referral data, use it to help understand opportunities for shoring up your network of providers, nurturing new patient pipelines and actively recovering any relationships in distress. Similarly, working with external claims data can help you visualize what shared patient connections exist outside of your organization, so you can develop more effective target lists.

Have you added a new or exclusive sponsor? (i.e. a payer)

If so, use internal and external data to understand which providers work with this base of patients most frequently and, therefore, should be notified.

Is there a key provider poised to refer to your team?

Understanding not only who the independent providers are in your market, but also those who are weakly aligned with the competition, may present an opportunity for a shift in market share and volumes.

What are your top barriers to access?

When it comes to growing a service line, there is nothing more challenging to overcome than access constraints. While physician liaisons are not in a position to fix these personally, you can provide your operational leaders the field intelligence needed to prioritize and potentially resolve any issues.

This applies to service and quality concerns that come up as well. Take the time to understand the issues that are brought to your attention by asking…

How often does it occur? Is it unique to this provider, or are others bringing up the same concern?

Are competitors experiencing similar constraints? Does the provider have any feedback on potential solutions they would like to see in place?

Capture this information, including key metrics, so you can share it in a way that helps your operational leaders clearly see and resolve each issue.

What process improvements are service line leaders working on?

While liaisons are mostly reactive when it comes to gaps in the referral process, it can be helpful to understand what improvement projects are currently underway within your organization. Ask your service line leaders what process improvement or ‘LEAN’ projects they are currently working on and how they are going. This can not only help you be aware of potential hot topics in the field, but also be able to positively address that you are already aware and actively working on the issue.

Are you getting ahead of payer changes?

Earlier I mentioned gaining a new or exclusive sponsor (i.e. a payer). There are times when the opposite occurs. When this happens, it can create some natural declines in market share. Be proactive by using internal and external data to understand which providers work with this base of patients most frequently. From there, work with your leadership team to understand key talking points about this change in relationship status.