Mythbuster

Are employed PCPs more likely to refer within their health systems?

Many health system leaders think that employing primary care physicians (PCPs) will secure in-network referrals, but the data tells a different story. Find out why employed PCPs are only slightly more likely to refer in-network than out-of-network for specialty care, and discover the financial impact of referral leakage.
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Many health systems believe that employment secures primary care physician (PCP) referrals. However, PCP employment doesn’t guarantee network integrity. Our data analysis reveals that it’s a coin flip. PCPs are only slightly more likely to refer in-network than out-of-network for specialty care.

Only 55% of total referral revenue attributed to employed PCPs is realized in-network.1 Said another way, PCPs send 45% of their referral revenue to competitors. Taken together, this referral leakage costs $388M in annual revenue per system.


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INTENDED AUDIENCE
  • Hospitals and health systems
  • Physicians and medical groups

AFTER YOU READ THIS
  • You will learn whether employed PCPs are more likely to refer in-network.
  • You will understand the opportunity size from improving referral leakage.
  • You will begin to distinguish between what does and doesn't lead to network integrity.

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