Halley Consulting Group And Athenahealth Publish Comprehensive Review Of National Referral Patterns From Primary Care Practices

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 ReferralView SM 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 VaccineView SM, 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.

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Copyright Business Wire 2010

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