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Network Utilization

What is network utilization?

Network utilization describes the practice of physicians referring patients to other in-network specialists and physicians. Hospital networks and providers typically encourage network utilization to maximize revenue and coordination of care.

Improving network utilization relies upon the following:

  • Provider relationships
  • Access
  • Quality of care
  • Consumer marketing

A crucial element of network utilization is minimizing referral leakage, which occurs when a physician refers the patient to a doctor outside of the network. The doctor may do this because they had a negative experience when referring a patient to a particular physician in the past, or they may choose to refer the patient to a past colleague.

There are also reasons for out-of-network referrals that are outside a health system’s control, such as a patient’s urgency or disagreements with a doctor’s advice.

How does network utilization improve healthcare?

Network utilization improves healthcare by promoting higher-quality care. By referring a patient to another in-network provider, the patient’s health information can easily be shared through the electronic medical record (EMR), enabling better care coordination and limiting repetitive and unnecessary tests performed on the patient, which also limits costs.

Additionally, network utilization often leads to a smoother process for patients regarding scheduling appointments, transmitting medical records, and navigating patient portals. The easier it is for patients to complete these tasks, the more satisfied they tend to be in their care.