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Provider Networks Referral Leakage

By Claire Thayer, April 16, 2015

Containing patient referrals within a provider network is easier said than done, even with electronic health records.  According to Joel French, CEO of SCI Solutions, "more than 25 percent of orders and referrals from employed providers leak out of network."  Chief Financial Officers across the country cite referral leakage as a top concern. According to a recent survey, 51% of CFOs list reducing network leakage as the most successful methods for generating future revenue growth. 

MCOL’s infoGraphoid for this week takes a look at some of the root causes of referral leakage as well as identifies seven ways to contain the leakage:

MCOL’s weekly infoGraphoid is a benefit for MCOL Basic members and released each Wednesday as part of the MCOL Daily Factoid e-newsletter distribution service – find out more here.

Reader Comments (1)

I have spent about 40 years in DoD hardware and software engineering in Boston Military-
Industrial Complex. Much exposure to secure ComSec technologies at Raytheon, MIT, Harvard, GE, and Sylvania. Since retiring to Atlanta I learned that there is a massive up-
grade underway changing the net parameters to Ultra Wide Band which allows very strong
encryption, i.e.,1024-bit crypto key length (or even 2048 or 4096). The communication
Godzillas: AT&T, IBM, Google, Cisco, HP, Juniper, Zayo and others, many of them foreign
are implementing independent virtual network environments that allow very fast modify-cations to network topology modeled on software development practice with what will en-tail military style crypto key management, a very strenuous and labor intensive organ-ization . Insight into this tsunami of technical change can be had from the Nov. 2014 Harvard Business REview article "The Internet of Everything" and a summing-up article
in the Oct. HBR by Micheal Porter head of the Harvard Business School which inspires some severe reservations. The very stringent disiplines that characterize military informa-tion and communication behaviors will, if adopted by Health Care organizations, cause
substantial ontological heartburn. Nevertheless, secure work-at-home, education distribution via the new net, and Internet Health Care delivery appear inevitable. There
is visible tilt away from familiar lexical/textual communication towards extremely high
resolution HDTV. Medical providers can look forward to instant limits-of-visual-acuity
television conferences with patients and each other. The intended nano network of real-time patient information via networked high-tech sensors installed on the patients will
obviously provide an "instant" constant stream of patient-parameter Big Data for analysis.
This new style of continuous Internet-centric monitoring presents a whole brave new world
of insight if the real-time stream of analytic data is cogent A valuable learning experience.
There will be a constantly refined streams of telemetered data to be verified. Just what
the doctor ordered without perhaps realizing the complications to ensue. Lawyers? An
embarrassment of riches, n'est pas? Certainly needs an unprecedented amount of work.
Howard Hubbard Antique Geek, Atlanta.

November 2, 2015 | Unregistered CommenterHoward Hubbard Atlanta

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