How to Simplify and Improve Physician Referrals With Data

There’s nothing wrong with traditional referral methods but decision support technology can help simplify the referral process for both physicians and patients.

Sub-optimal referral decisions could affect patient outcomes and experience, which are the most important considerations. However, with the growth of value-based care payment models, where reimbursement is based on costs incurred, referrals are an important consideration for financial performance, as well.

Claims data will offer insight on costs, but health systems and ACOs – if the referral physician is unaffiliated – may need to partner with a third-party data provider to fill gaps in claims data for care delivered outside the network.

All of this data can be automatically compiled and analyzed using population health management technology that can deliver a numerical score for each physician in the referral network based on patient factors and the physician’s performance across multiple quality and cost metrics.