Patient Leakage refers to the phenomenon where patients receive healthcare services outside the primary network or system in which providers and facilities have a financial interest. This can occur when patients seek care from out-of-network providers, leading to a loss of revenue for the healthcare organizations that initially captured the patient.
Understanding patient leakage is essential because it directly impacts a healthcare organization’s financial performance, patient outcomes, and the overall integrity of care coordination.
Patient Leakage is crucial to healthcare as it affects both financial and clinical outcomes. Financially, when patients utilize out-of-network services, affiliated healthcare systems lose potential revenue, impeding their ability to invest in improved patient care, technology, and facility enhancements. Clinically, patient leakage can disrupt continuity of care, which may lead to fragmented treatment and poorer health outcomes.
Furthermore, effectively managing patient leakage is important for maintaining robust patient-provider relationships, optimizing resource allocation, and ensuring that care is coordinated within the trusted network, enhancing patient satisfaction and loyalty. Addressing this issue helps healthcare organizations maintain a competitive edge and deliver high-quality, integrated care.