Referral leakage
Definition
Referral leakage is when patients referred for care go to providers outside the referring health system or network, often because the right in-network provider was hard to find or the referral information was wrong.
By the Candor Health team
Last reviewed
Also called patient leakage and network leakage
Why does referral leakage happen?
Referring clinicians and patients can't easily see which in-network providers are available, nearby and suited to the need. When the internal directory is wrong or incomplete, they pick whoever they can find.
Why does it matter?
For health systems, leakage means lost revenue and broken continuity of care. For patients, it can mean higher costs and records that don't follow them.
How does provider data help?
Accurate, searchable data on which providers practice where, what they treat and which plans they accept makes it easier to keep referrals in network.