Tools to reduce referral leakage in the medical group

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Not sure where to begin? The guidance in this report is organized into three sections:

• Upgrade traditional referral practices
• Identify and prioritize leakage opportunities
• Streamline referral operations

To help medical group leaders implement the tactics outlined in the report, we’ve compiled a collection of member-developed and Advisory Board tools to jump-start leakage reduction at your organization.

Upgrade traditional referral practices (p.7)

• Talking points for generating buy-in for in-network referrals
  Use these talking points to highlight how in-network referrals can improve patient experience and physician workflows—two important physician values.
• Referring physician engagement tip sheet
  Help specialists highlight what PCPs care about most—communication and service—with this tip sheet, created by NorthShore Medical Group.
• Administrator guide to physician meet and greets
  Read this cheat sheet, created by NorthShore Medical Group, for tips on embedding referrals discussions during new physician onboarding and making new physician introductions more meaningful.

Identify and prioritize leakage opportunities (p.13)

• Picklist: Opportunities to quantify referral leakage
  Don’t have the capacity to track leakage? Review this list of alternative data sources to assess other ways to quantify referral leakage at your organization.
• Tips for productive conversations with physicians
  To make meetings more productive, frame referral conversations with physicians as bidirectional, not a mandate to refer in-network. Use these tips to have more meaningful conversations with clinicians about referrals data.

Streamline referral operations (p.19)

• Common metrics used to rank physicians for referral
  Use this list to develop a data-driven process for referring to the right in-network sub-specialist. Commonly cited-metrics include patient insurance, convenience, and for groups in risk-based contracts, quality and cost.
• Diagnostic: Selecting a model for referral management
  Use this diagnostic to choose which model—decentralization, centralization, or direct scheduling—will be easiest to implement for your group. Then, review the associated case studies to learn how medical groups implemented each model.
• Decentralization: Successful decentralized models automate and standardized aspects of the referral process across practice sites, but maintain staff at individual sites. Learn how Brigham Health deployed a decentralized model. (p.28)
• Centralization: This model removes referral coordinators from individual practice sites. See how Virtua Medical group provides a more consistent patient experience through centralization. (p.30)
• Customer service training: Review how Virtua trains its access navigators on active listening, proactive outreach, and service to provide a best-in-class patient experience.
• Direct Scheduling: This model uses a unified EHR system so that staff at one practice can see and schedule appointments at another practice, regardless of their specialty. Learn how CoxHealth successfully implemented direct scheduling. (p.32)
• Direct scheduling workflow: See how CoxHealth mapped out a workflow for integrating direct scheduling capabilities into its EHR.
• Sample job descriptions: referral coordinators
  Looking to hire the right staff for newly formed referral coordinator roles at your organization? Use these sample job descriptions to guide your efforts.
  • AdventHealth referral coordinator job description
  • Virtua access navigator job description