Data Reinforces Value of Primary Care and Importance of Referral
Management for Medical Staff Planning
COLUMBUS, Ohio & WATERTOWN, Mass.--(BUSINESS WIRE)--Oct. 22, 2012--
Halley
Consulting Group, a firm serving hospital, health system and private
practice physician clients nationwide, and athenahealth,
Inc. (NASDAQ: ATHN), a leading provider of cloud-based, electronic
health record (EHR),
practice
management, and care
coordination services to medical groups and health systems, have
announced the results of a joint study on national referral patterns
from more than 1,000 primary care specialists nationwide.
The inaugural ReferralViewSM
study examines the following questions: What specialists and services do
primary care providers (PCPs) refer to most often? How do referrals vary
among different kinds of PCPs, in different regions of the country? How
can physicians and health care system executives use referral data to
inform their growth strategies, better coordinate care, and meet quality
of care standards?
Among the key findings were the following:
-
Family practice and internal medicine providers referred at rates of
25 percent and 29 percent, respectively, underscoring the large volume
of referrals these primary care practices must manage.
-
The top referred-to specialties included gastroenterology, orthopedic
surgery, physical therapy, dermatology, and otolaryngology (ENT), with
some variation among primary care specialties.
-
Regional trends indicated referral rates were highest in the West and
Northeast, most likely due to the predominance of rural areas in the
Midwest and South, penetration of HMOs in the West and Northeast, and
higher median patient age in the West.
“Our findings provide a strategic framework for hospitals’ medical staff
planning process—determining the mix of physician specialties and other
healthcare professionals required to meet demand and remain
operationally viable,” said Marc Halley, president and CEO of Halley
Consulting Group. “Additionally, the data provide a gauge to indicate
whether or not a specialty physician is the provider of choice among
referring PCPs—whether or not specialty physicians are attracting the
optimal number of referrals.”
“ReferralView is a perfect example of how data-driven insights from our
cloud-based network can be used to make health systems and medical
groups function more efficiently,” said Jonathan Bush, President & CEO
of athenahealth. “The data we’ve uncovered in ReferralView will help
health systems better understand referral patterns, pinpoint referral
‘leakage,’ and ultimately improve care coordination. For PCPs, this data
sheds light on all the work they do and the value they create in the
system—value we are now making sure they get paid for.”
Referral tracking has gained increasing importance as hospitals and
medical groups strive to meet quality and compliance standards required
for Patient-Centered Medical Homes, Accountable Care Organizations
(ACOs), and other models that tie payment to measurable outcomes.
Risk-based payment mechanisms are focused on coordination and tracking
of patient care and will dictate more significant and more frequent
clinical communication between physicians, hospitals, and other health
care providers.
ReferralView, an ongoing series from athenahealth that includes analysis
from Halley Consulting Group, is a product of the data that athenahealth
continuously compiles and manages on behalf of its 38,000 medical
providers across the country. Each athenahealth client shares the same
version of cloud-based software. This means that every aspect of an
encounter—including patient referrals—is captured electronically across
athenahealth’s national network of providers, providing a unique and
growing research database. ReferralView is the latest in a series of
studies that athenahealth’s research arm has issued based on its network
data. These include PayerView®, the industry’s leading
quantitative analysis of the payer-provider relationship, and VaccineViewSM,
the first of its kind examination of vaccine reimbursement trends.
Look for a detailed review and analysis of the ReferralView results in
the April 2013 issue of hfm. To download the ReferralView study,
visit http://www.athenahealth.com/ReferralView.
About Halley Consulting Group
Halley Consulting Group, LLC, is a physician practice management and
consulting firm specializing in the strategic development and
performance turnaround of hospital-owned practice networks and
independent medical offices. Halley Consulting Group works with clients
nationwide, including large hospital systems, individual hospitals that
own ambulatory networks and private practice physicians. They provide
services through traditional consulting arrangements and interim
management contracts.
The firm’s president and CEO, Marc D. Halley, MBA, is a frequently
requested speaker and has authored several books, including The
Primary Care Market Share Connection: How Hospitals Achieve Competitive
Advantage and The Medical Practice Start-Up Guide. He also is
a contributor to The Business of Healthcare. His third book, Owning
Medical Practices: Best Practices for Sustainable Results, was
released by the American Hospital Association in January 2011. For more
information about Halley Consulting Group, visit www.halleyconsulting.com.
About athenahealth
athenahealth, Inc. is a leading provider of cloud-based electronic
health record (EHR),
practice management, and care coordination services to medical groups
and health systems. athenahealth’s mission is to be the most trusted
service to medical care givers, helping them do well by doing the right
thing. For more information, please visit www.athenahealth.com
or call 888-652-8200.
Photos/Multimedia Gallery Available: http://www.businesswire.com/cgi-bin/mmg.cgi?eid=50448449&lang=en
Source: athenahealth, Inc.
R/P Marketing Public Relations
Kate Blyt, 419-241-2221
Client
Relations Manager
kblyth@r-p.com
or
Media
athenahealth,
Inc.
Amanda Cheslock, 212-446-1884
acheslock@athenahealth.com
