More than 55% of patients referred to health system physical therapy clinics are seeking care elsewhere––a trend that is costing provider organizations billions of dollars annually, according to a new report from Luna.

The scale of this referral leakage points to rehab/physical therapy primary driver of such losses in health systems. Indeed, even those health systems most successful at patient retention are losing substantial amounts of patients and revenue, with the majority having leakage rates well above 50%.

These insights and more are revealed in The Hidden Problem Costing Health Systems Millions: Rehab Referral Leakage, a new national study of referral leakage in health system physical therapy programs. The study, issued by Luna analyzed claims data from 3.4 million patients, and reveal that the related health systems lost more than $2.5 billion in revenue in 2019, a media release from Luna explains.

Key Findings

Key findings from the report include:

  • More than 1.9 million of the 3.4 million patients analyzed (55.9%) left the referring health system for physical therapy care.
  • While the majority of health systems have leakage rates of at least 50%, some systems see more than 80 percent of their referrals seek care elsewhere.
  • For patients seeking in-network care, a primary driver is proximity to a clinic, with patients unwilling to travel more than a few miles to an affiliated clinic before seeking care elsewhere.

“Many health systems have been successful in running a low- to mid-margin physical therapy service line. That being said, maintaining patients, particularly with the abundance of third-party clinics and other options for individuals to choose from, is limiting the potential upside. This analysis sheds light on the magnitude of opportunity that exists and illustrates the financial toll that leakage can have on health systems’ bottom lines.”

— Ryan Lewis, Head of Business Development for Health Systems at Luna

Health System vs Outside Provider

The analysis was conducted using U.S. commercial health care claims data compiled by Definitive Healthcare. Luna analyzed the number of patients prescribed physical therapy by a health system and the number who sought care from a different provider within the same metro area. The analysis does not capture patients who did not seek care at all, meaning the true leakage statistics are even higher than the data suggest.

Luna helps solve the leakage problem for health systems by providing partners access to their broad network of local therapists, meaning systems can provide services through Luna to the entire geography they need to serve without needing to build new clinics. Partner systems also gain access to Luna’s award-winning technology platform, which enables the mobilization of quality care in the field, along with Luna’s sophisticated processes, resources, and support.

Already, prominent health systems like EmoryScrippsEvergreenHealth, and the Baylor Scott & White Institute for Rehabilitation have partnered with Luna to help reduce PT referral leakage rates. Luna works with health systems, physical therapy groups, and orthopedic groups to provide at-home care via in-person delivery in 32 markets and 19 states across the country, Luna notes in the release.

The report, in The Hidden Problem Costing Health Systems Millions: Rehab Referral Leakage, is available for download.

[Source(s): Luna, PR Newswire]

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