True or False: Physician Referrals Are Affected by Distance

True or False: Physician Referrals Are Affected by Distance

A Surprising Trend in Patient Care Patterns

By Dave Sellers

We recently tested a theory as to whether or not distance to a physician referral affects how quickly a patient seeks care.* All other factors being equal, we hypothesized that patients would not act as quickly in scheduling a physician visit if that physician is far away. Conversely, if the doctor is close by, we assumed patients would be more likely to book their appointment sooner.

In a previous post, we discussed a similar idea. Are patients more likely to go to the hospital closest to them when in need of care? In that case, tif all other factors are equal, then the answer was yes. But rarely are all other factors equal. Factors such as a hospital's CMI, their community perception, and relative patient satisfaction rates all come into play and can often be more important than proximity.

With this new theory, we were still considering the role of distance, but this time, we wanted to know how it would affect a patient’s responsiveness when needing to schedule time with a referred physician. Our findings surprised us.

On a national basis, for all claim types and referral specialties, there was no significant correlation found between distance travelled for treatment and the duration between referrals.

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Click to tweet: True or False? Physician referrals are affected by distance. @stratasan

Our research considered patient data from 2016Q4–2017Q3 and analyzed inpatient, outpatient, skilled-nursing facility, hospice, home health agency, and carrier claim types. Correlation strength of +/- .30 is the minimum threshold to be deemed significantly directional. When broken down by state, no individual state showed a significantly strong correlation; when broken down by claim type, no single claim type showed a significantly strong correlation. When broken down by specialty of the physician receiving the referral, oral surgery has a moderately positive correlation of +0.44. None of the other specialities met the significance threshold.

Aside from the surprising lack of a statistical correlation between distance and the duration between referrals, we did uncover some noteworthy findings based on the summary statistics we generated.

  • Average distance travelled to care (the distance travelled from Patient ZIP to Referral Facility ZIP) was 13.8 miles (note: 50.2% of patients were able to receive care in their home ZIP code).
  • Average referral time (how long after the initial visit was the referral acted upon) was 23.1 days.

State highlights:

  • There was limited variation from state to state in terms of the duration between referrals (48 of 51 states have a 20-to 26-day average referral period).
  • Generally, Western and Midwestern states have the farthest average distance to travel for service.

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Click to tweet: Generally, Western and Midwestern states have the farthest average distance to travel for service. @stratasan

Claim type highlights:

  • Hospice claims averaged the farthest distance to travel, while inpatient claims required the least travel, on average (72.7% of inpatient encounters occurred in the patient’s home ZIP).
  • Hospice claims had the longest referral duration (32 days).Screen Shot 2018-04-16 at 12.37.42 PM
  • Skilled Nursing Facilities had the shortest duration (20 days).

Specialty highlights:

  • Specialties requiring the least travel include addiction medicine, proctology, preventative medicine, and sports medicine.
  • Specialties requiring the farthest travel include pain management, gynecological oncology, and transplant cardiology.
  • Optometry, pain management, geriatric psychiatric, and podiatry have the longest referral duration (31 +/- .25 days).


The Takeaway

For physician liaisons looking to foster and develop physician and provider relationships, consider this an opportunity to pursue and develop relationships with the best care providers possible, even if they aren’t adjacent to your hospital. Our findings show that patients are more concerned with getting the right care over getting the closest care available, particularly with regard to referrals. This was shown to be particularly true in speciality areas such as pain management, gynecological oncology, and transplant cardiology.

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Next Steps

Get to know your customer base. Through Tapestry Segmentation, you can understand your customers and their lifestyle choices in ways that will inform and influence your growth strategy. Get insight as to optimal sites for new hospitals, physician offices, FSERS, and urgent care facilities. Stratasan’s team of mapping experts can guide proper use of the Tapestry Segmentation dataset to ensure you see higher response rates, focus on the most profitable growth opportunities, and invest your resources in the best possible ways.

Choose a mapping software and track patient out-migration, physician loyalties, and service area opportunities. As we’ve discussed, many factors influence a patient’s decision on when and where to get care. The more informed you are about patient and physician patterns, the better equipped you will be to ensure your site selections are optimally positioned for increased revenue and market share.

Review historical data at the block-group level for insight into previous-year trends and fluctuations that can guide growth planning and arm you with the intelligence for informed and effective market growth.

Lastly, request a discovery call with Sean Conway today and find out how Stratasan can support your annual growth goals and guide your team through a successful strategic planning process.

 find out if physician referrals are affected by distance

Article by Dave Sellers, Data Specialist for Stratasan

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*This research was performed using CMS data

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