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Patient Leakage

What is patient leakage?

Patient leakage is when a patient seeks or obtains healthcare services at a location outside of the hospital network. It may also be referred to as referral leakage or patient referral leakage.

There are many reasons why a patient may choose to seek care from another location, such as convenience in location if the patient works in a different area than they live, the need for healthcare services not offered by the hospital network, lack of trust with the hospital, or a recommendation by a friend or family member.

Healthcare organizations can reduce patient leakage by supporting in-network referrals and simplifying the process. Additionally, organizations can create repositories of provider and specialist information, which can help and encourage physicians to refer in-network specialists.

How does patient leakage affect healthcare?

There are some problems that come with patient leakage, such as:

  • The patient loses care continuity, which can be frustrating for the patient and lower their health outcomes.
  • The out-of-network specialist may not have full access to the patient’s medical records.
  • The health system loses revenue.
  • The health system can no longer track the patient’s healthcare journey and progress, which can make future treatments difficult.
  • There may be inefficiencies in the referral process, which can lead to delays in care and duplicate testing.

By addressing the major reasons for patient leakage, healthcare organizations can work on reducing its occurrence while also providing better patient care.