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Using Technology to Maximize Out-of-Network Referral Capture

By Dr. Jen Volland, VP Program Development, NRC Health


Patients and their families are increasingly struggling with the high cost of healthcare as they determine where they want to receive services. In 2016, NRC Health was one of the first sources to identify that Millennial-cohort purchase behavior included online reviews as an important part of the healthcare decision-making process. The NRC Health Market Insights data showed a definite shift toward leveraging technology and human understanding to gain insight into why patients and consumers are attracted to different brands.

If you’re lacking online ratings and reviews as part of a brand strategy, consider the following:

  • 83% of 18-to-34-year-olds view online ratings and reviews before purchasing a product
  • 82% of 35-to-44-year-olds view online ratings and reviews before purchasing a product
  • 69% of 45-to-64-year-olds view online ratings and reviews before purchasing a product

If your online branding strategy isn’t focusing on your full population, you’re already experiencing the out-migration of those who access online ratings and reviews as an important part of their decision-making process. The power of the Internet is as evident when consumers are selecting physicians as when they’re purchasing products: depending on the cohort age, the use of online ratings and reviews in doctor selection can range from 44.8% (among those aged 65 and up—a percentage that continues to rise) to 48.1% (nearly half of 18-34-year-olds).

Using NRC Health’s Transparency program increases your online visibility, drives new customer acquisition, builds provider engagement, and protects your brand with improved performance. Of our partners who incorporate a robust program of examining what’s posted online, 98% land in the top spot of a search, dramatically increasing their visibility and traffic to their providers’ reputation data.

Out-of-network opportunity, gained through collaborations and interactions with outside colleagues who can refer to your clinical practice, is often an untapped area of growth. Out-of-network referrals are often due to operational issues in the referral process—not to physician choice. Combine that with the fact that 58% of independent providers state that they don’t have a preferred referral partner, and the magnitude of opportunity becomes clear. Your practice needs to be user-friendly, not only to patients and PCPs, but also to those providers who refer to you.

What helpful insights are useful to providers, and particularly to new staff in your practice, who may not already have a referral base built up?

  1. Use data to determine out-migration. Referral data should be used to drive strategy. Most organizations track referrals but fail to track the specific reasons that those referrals are being sent out-of-network.
  2. Provide structure to the clinical referring process. This includes designing processes with the patient/family at the center; having clarity with physician expectations, accountability, and responsibility for ensuring that the loop gets closed with referrals; ensuring consistent workflows that minimize administrative burden and use the E.H.R. to generate referrals; resolving interoperability issues to ensure a smooth process flow; and measuring the referral process by effectiveness (understanding why patients migrate to your clinic or practice and why they leave, and subsequently positioning your physicians at the highest level possible on the Internet to enhance their visibility).

How do you measure success?

  • Hold an individual accountable for the referral process.
  • Make sure your referral physician (or specialist back to the PCP) includes the necessary information. Many times, the information being sent is more than the consult needs, creating the need to search for the most important information. If you don’t know which sections of your referral are most important, ask.
  • Develop processes to keep track of the status of all referrals and patient transitions, and everything that experience includes.
  • Determine whether patients are reporting that they need more help coordinating their care.

The technological solutions put into action must include easy workflows. NRC Health’s Transitions program links patients back to the care-provider team to discover areas commonly known to cause readmissions. Not only should your physicians have top placement on the web, post-encounter outreach needs to include questions about the medications that a patient is on daily, and any other top-of-mind reasons they may have for readmission.

While ratings and reviews should be a top priority, ensuring that patients enjoy a safe and delightful encounter with your organization requires the same level of attention. In an era of clinician burnout, technology can be used to identify those patients at the highest risk for readmission, so that follow-up can occur instead of a visit to the Emergency Department. Patients report that they want help getting the care they need, and that they want to provide their feedback—and NRC Health’s Transitions can further boost your word-of-mouth referrals by resolving any medical concerns or questions immediately post-discharge.

To capture network seepage, you need to know both why patients leave your organization, and why they stay, and satisfy the consumer’s desire to find top providers rapidly during searches on pages like Google. Technology can help your organization with all of these priorities when incorporated as part of a larger strategy that blends market outreach, issue identification, and employee and provider engagement. Accurate and rapid insights into the customer’s voice are a must-have for healthcare organizations operating within any consumer paradigm; with them, you can create increased volumes using consumer feedback and ratings, better understand the patients you’re losing to other providers, and place your providers at the top of searches.

Utilizing technology to maximize your referrals and decrease network seepage is now more important than ever before, given patients’ new willingness to travel to their preferred location for care. And with such high rates of independent providers stating they don’t have a preferred referral partner, keeping patients in your healthcare delivery system—and forming solid relationships across providers—is essential to capturing and retaining today’s patients.