Patient leakage, also known as patient referral leakage and referral leakage, describes when a patient seeks or obtains healthcare services outside the hospital network.

According to a recent report, 55 percent of patients sought rehabilitation services outside of the system or organization following surgery, resulting in $2.5 billion in lost potential revenue. The report, cited in Modern Healthcare, examined 3.4 million commercial claims with the assistance of analytics from Definitive Healthcare.

As it relates to the physical therapy market, more than half of patients referred to physical therapy end up seeking care at third-party clinics or pursuing other options. Most systems have leakage rates of more than 50 percent, and in some cases, nearly 80 percent of an organization’s referrals will go outside of the system.

Consumers might be willing to travel a long distance for a particular procedure, or even drive a distance for a follow-up with a specific doctor, but when it comes to PT, they are more likely to go to wherever is closest. A typical episode of physical therapy averages 12 to 13 visits; and while many patients will travel far for a surgery, they won’t travel as far for weeks of physical therapy.

According to IBISWorld, as of December 29, 2021, there are over 43,000 PT clinics in the United States. In a report from HealthCare Appraisers, they estimate the number of clinics to be over 38,000. In the same report, HealthCare Appraisers estimates the distribution of outpatient therapy spending by setting as:

38%      Nursing Facility

34%      PT Private Practice

15%      Hospital

9%      ORF, CORF & HHA

3%      OT & SLP Private Practice

1%      Physician and non-physician Practitioner

Every year, healthcare organizations operating on already compressed margins, continue to hemorrhage patients and revenue due to unresolved leakage issues. Recent research indicates that rehabilitation referrals are the largest driver of leakage in health systems. The challenge is to find partners with the knowledge and experience to assist you in recapturing those lost revenue patients through creating a robust therapy department that beckons patients to stay.

Sources:

HealthCare Appraisers
Modern Healthcare
Definitive Healthcare