Transitions—when patients move from one care setting to another—represent a state of vulnerability for both the patient and the healthcare organization. Patients need referrals to the most appropriate provider in a timely, seamless fashion so they get the level of care they need. If patients leave the network, it could result in revenue leakage for the provider organization. I’ve heard healthcare leaders estimate that between 20-30% of their patients ultimately leave their network during a transition of care. This renders the care team less able to ensure patients get the best possible care—and less able to track patient progress and monitor follow-up. Plus, it means missed revenue opportunities. When patients see out-of-network ambulatory or post-acute providers, healthcare networks are unable to capture the revenue that would otherwise be associated with patient care. There are downstream financial effects, too. When patients […]
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