< Back to Thought Leadership

Referral Development within Outpatient Physical and Occupational Therapy

When looking at your Outpatient Physical and Occupational Therapy departments, have you noticed a decrease in the volume of outpatient services? At Blue & Co. we often find that many hospitals and hospital systems have viable candidates for outpatient therapy services but are being seen by another healthcare organization due to a lack of a tight referral development process.

Referral Development: Back Pain Case Study

Providers know that patients will often go to the Emergency Department for back pain when they can’t get an appointment quickly with their primary care doctor. According to this study by Elite Learning, many providers will simply prescribe pain medication and send the patient home. A number of patients that are seen due to back pain meet the profile to be referred internally to the hospitals’ Outpatient Physical Therapy department.

So why doesn’t the Emergency Department refer more people to Outpatient Physical Therapy? Here are a few of the barriers:

  1. Providers do not want to interfere with the relationship between primary care providers and the patient
  2. Providers often don’t want to deal with the administrative duties that are associated with referring a patient to another department
  3. Providers might not know how to refer patients internally to the Outpatient Physical Therapy department

How to Build an Internal Referral Program

The Emergency Department is just one example of a setting within a healthcare organization where patients have a touch point where they might be a good candidate for an internal referral. As you build out or redefine your referral development program, consider the following:

  • Identify the settings in your organization you should focus on (Emergency Department, Inpatient discharges, observation discharges, etc.)
  • Educate the healthcare providers on what differentiates your organization’s outpatient therapy department from the average free-standing therapy clinic. For example, hospitals typically provide one-on-one therapy and freestanding clinics typically do not
  • Work with your IT personnel to make the trigger system dependent. For example, in the Emergency Department, inculcate the Low Back Strain family of diagnoses so that it sends a “best practice alert” to the provider to consider a referral

In each setting, the challenges and barriers of making a referral needs to be assessed and addressed. Many providers will default to the generic advice for the patient to follow-up with their primary care provider, with the expectation that the primary care provider will guide the patient through the referral process. A number of patients will not follow up with their primary care provider and that a number of patients cannot get an appointment in a timely manner with their provider.

Contact Blue about Outpatient Therapy Referral Development Opportunities

Could your organization be missing out on these referral development opportunities? Our team has helped multiple hospital systems work through these barriers and most of our clients experience a significant referral rate once fully implemented.

Our Outpatient Therapy Business Advisory Services provides both Assessment and Implementation Guidance to help hospitals understand their revenue and growth opportunities and facilitate changes in processes and behaviors to achieve them.

Contact John Britt or your local Blue & Co. advisor to learn more about Outpatient Therapy Referral Development.

John Britt, Senior Manager

Blue & Co., LLC Announces New Partnership With Vsimple | Vsimple and Blue and Co logo

Blue & Co., LLC Announces New Partnership With Vsimple

CARMEL, Ind. (May 5, 2022) – Blue & Co., LLC is excited to announce our new partnership with Vsimple, a workflow management software company based in New Albany, IN.  Blue & Co and Vsimple will be working closely together to address the workflow and process improvement challenges of manufacturers throughout the Midwest. “At Blue & […]

Learn More
Proposed Rule FY 2023 for Skilled Nursing Facilities

Proposed Rule FY 2023 for Skilled Nursing Facilities

It is that time of year again! The Center for Medicare and Medicaid Services (CMS) has issued the proposed rule that would update Medicare payment policies and rates for the fiscal year (FY) 2023’s Skilled Nursing Facility (SNF) Prospective Payment System (PPS). The Patient Driven Payment Model (PDPM) was implemented on October 1, 2019. This […]

Learn More
Coverage Scheduling Solutions for Physician Practices and Hospital Systems

Scheduling Solutions for Clinician Work-Life Balance

One of the most challenging conversations in any multi-physician practice or specialty-based hospital employed group is about how to create a fair distribution of on-call and/or inpatient hospital service coverage while balancing the duties of an outpatient practice. The COVID-19 pandemic has contributed to clinician burnout, and physicians and Advanced Practice Providers (APPs) place significant […]

Learn More