Back to Blog

Referral Patterns in Healthcare: The Key to Growth

With so much competition in the long-term and post-acute care (LTPAC) market, maintaining growth takes work. Because of the rapid expansion of the over-65 demographic, it’s essential that LTPAC organizations and referring physicians understand the impacts of referral patterns in healthcare. The networks you participate in affect your ability to attract hospital referrals and drive new revenue.  

What are Referral Patterns?

Referral patterns are the processes that hospitals and physicals use to move patients from one care facility to the next. For example, when patients are ready for discharge from a hospital but still need extended care, they typically get referred to an LTPAC facility.

In the traditional healthcare referral pattern, you had physician groups acting in a sort of lobbyist role to get patients directed to their choice of LTPAC facility. They established personal relationships with hospital personnel and even offered gifts and other perks. Because decisions were based on personal relationships rather than health metrics, patients sometimes ended up in facilities unequipped to handle their health needs.

Those informal connections also increased the potential financial risks for both patients and hospitals. For example, patients released to an LTPAC too soon are more likely to return to the hospital for another costly stay.

The financial stakes for hospitals were compounded by the October 2012 Hospital Readmissions Reduction (HRR) Program. The program aimed to ensure that hospitals gave patients the proper level of care and weren’t referring to LTPAC environments before they were ready. Any hospital with high Medicare patient readmission rates faced hefty financial penalties. Because of that, hospitals and LTPAC facilities started paying closer attention to what happened to patients when they left the hospital.

How are Referral Patterns Evolving?

In the traditional healthcare referral pattern, the informal relationships hospitals formed with various physicians’ groups, rather than patient needs, often influenced a patient’s LTPAC destination. Now, hospitals understand the costs of not looking beyond a single recommendation. Instead, they’ve shifted to working with a smaller network of trusted LTPAC providers with proven experience helping patients receive quality care.

Hospital executives have turned to data analysis to inform their LTPAC referrals. They examine how many patients the LTPAC facility returns to the hospital and pay attention to what patients say about their overall experience. Any facility that meets a hospital’s standard of care gets placed in its referral network. That doesn’t mean that the opinion of a referring doctor no longer matters. However, many hospitals now consider data an essential component of LTPAC referrals.

Data-driven health decisions enable better patient outcomes while reducing overall healthcare costs. There’s less risk of a patient bouncing back and forth between the hospital and LTPAC because of a lack of adequate care.

What’s Driving the Change in Referral Patterns?

Gone are the days when a physician’s group could drive business to their LTPAC with nothing more than clever marketing. These days, hospitals want to see metrics telling them that patients will be safe and well-cared for at a facility. They tend to look at LTPACs who already participate in their system of health plan preferred networks to save money for themselves and their patients.  

Some healthcare providers are partnering with companies that supply health data to fill information gaps. These companies provide information about LTPACs' accessibility for clients, primary languages, and ability to shoulder costs for patient care.

Modern LTPAC facilities can offer various services, including skilled nursing and home care. However, they must back up their capabilities with hard facts if they want to be included in a hospital’s LTPAC referral network. To maximize their role in the new referral patterns in healthcare, an LTPAC needs to join more preferred provider networks by showing an exemplary standard of care.

How LTPAC Facilities Can Build Referral Prospects

A better understanding of referral patterns allows doctors to influence patient care positively. Likewise, healthcare providers gain the ability to provide care beyond the confines of a hospital bed.

As an LTPAC provider, you can build your referral prospects by showing hospitals that you are taking purposeful steps to prioritize patient care, such as by:

  • Using data analysis and care metrics to show that you're capable of providing a high level of care to discharged patients.
  • Providing unique care options, such as home upgrades to accommodate individual medical needs, to give hospital physicians more faith in their referral.
  • Improving on your Merit-Based Incentive Payment System (MIPS) scores by focusing on quality, improvement activities, interoperability, and cost.

Ensure Better Health Outcomes With ChartPath

At ChartPath, our electronic healthcare record (EHR) platform allows providers to access critical data relevant to patient care. We also partner with referring software to make navigating the new referral patterns a breeze. Learn more about how ChartPath can play a part in attracting new referrals by trying out a demo of our platform.

Get Our Free MIPS 101 Guide

In this eBook you’ll learn: the purpose of MIPS, MIPS participation and measures, risks and benefits of scoring, and how the right technology can track performance to increase your MIPS score.
Download Now

More from the Blog

What is the Difference Between EMR and Practice Management?

Understanding the differences between Electronic Medical Records (EMR) and practice management systems is crucial for healthcare providers looking to improve their operations. These two types of software serve distinct roles in healthcare settings, yet they can complement each other in impactful ways.

Read Article

The Vital Role of Specialized EMR in Long-Term Care and Post-Acute Settings

The importance of efficient and tailored Electronic Medical Records (EMR) cannot be overstated in the ever-evolving healthcare landscape. For doctors who make rounds in skilled nursing facilities and Long-Term Post-Acute Care (LTPAC) settings, choosing the right EMR system is a decision that can significantly impact patient care, workflow, and overall outcomes. In this blog, we will explore why opting for an EMR explicitly designed for these settings is crucial and how ChartPath, at, offers a solution tailored to these unique needs.

Read Article

What are the Features of an EHR System?

Data is the lifeblood of long-term and post-acute care (LTPAC) practices. Patients with chronic and complex health conditions often have extensive medical records from multiple clinicians and facilities. Many LTPAC organizations use electronic health records (EHRs) to process and share this data. These digital files allow staff to provide the best and most accurate care. Choosing a quality EHR platform can feel exciting but stressful. Our handy EHR guide reviews 21 features to look for when selecting an EHR.

Read Article

Choosing an EHR for Behavioral Health Practice Needs

Every EHR system is different, which is why it is critical to choose your system carefully. You'll want to select a system designed for behavioral health with customization options, versatile features, and an integrated eRX to get started. You should also look for a system with dictation options as well as an intuitive interface. 

Read Article

Tackling Resistance to Change in Long-Term Care Solutions

Change is an inevitable aspect of progress, and the healthcare industry is no exception. In the ever-evolving medical landscape, Long Term Post-Acute Care providers (LTPACs) increasingly rely on Electronic Health Records (EHR) systems to enhance patient care. However, resistance from healthcare professionals and staff remains a significant obstacle, even in 2023. This resistance manifests in various forms, including reluctance to adapt to new workflows, fear of technology, and concerns about patient privacy.

Read Article

The MIPS 2023 Quality Measures

Learn everything you need to know about changes to the MIPS 2023 quality measures. 

Read Article

Choosing an LTC Charting System

Your long-term care (LTC) charting system affects every part of your practice, from clinicians to admin staff. Clinicians spend 1.84 hours each day using EHR software, so it’s the one tool that has the potential to cause major headaches and chaos if you get it wrong. Careful consideration of a few key factors and features can help you refine your search and find the best solution for your practice.

Read Article

Top 5 EHR Implementation Challenges (And How To Overcome Them)

Implementing an Electronic Health Record (EHR) system can present several challenges. Learn about those challenges and how to overcome them/

Read Article

The Importance of Gradual Dose Reduction in Your Behavioral Health Practice

Getting patients to accept the benefits of medication for their mental health issues can be challenging. There’s often a lot of trial and error that comes with finding the right dosage level to help them regulate symptoms. You may discover that reducing a patient’s reliance on specific medicines is beneficial. Gradual dose reduction (GDR) progressively minimizes a patient’s medication levels over time.

Read Article

Stop Denials Before They Start

Practices focusing on long-term and post-acute care (LTPAC) constantly battle with claim rejections and denials. These claim denials increase billing expenses and cause harm to revenue cycle management. Submitting clean claims with a high first-pass approval rate is crucial for prompt reimbursements.

Read Article

ChartPath Announces New Automation Platform for Long-Term and Post-Acute Care Practice

ChartPath, a leading EHR solution for long-term and post-acute care practices, today announced plans for a new automation platform that will allow clinicians and caretakers to select from a menu of helpful solutions and integrations tailored to their unique business and care needs.

Read Article

HCC Coding Basics: Run a Better Practice

Learn about HCC coding and how to run a better practice. Using HCC codes in an EMR helps ensure that patients with multiple chronic conditions receive appropriate resources for their care and that clinicians receive fair and accurate payments for the services they provide. This helps reduce costs and improve the overall efficiency of the healthcare system.

Read Article

ChartPath EHR Announces Enhanced Integration with PointClickCare

ChartPath, the leading EHR solution for long-term and post-acute care practices, today announced new enhancements to its ongoing integration with PointClickCare, a leading healthcare technology platform enabling meaningful collaboration and access to real–time insights.

Read Article

Promoting Interoperability Changes for 2022: Ace Your MIPS

If you participate in the Merit-based Incentive PaymentSystem (MIPS) program, you may know the Promoting Interoperability (PI)requirements. For participating clinicians, PI can account for up to 25% of your MIPS score. If you are unsure of PI requirements and are not meeting them, you may end up on the wrong side of a penalty. And your PI activities need to have started by October 1st because it’s your last chance to make the best impression. The Centers for Medicare & Medicaid Services (CMS) measures you on a 90-day reporting period. 

Read Article

Documentation Frustrations in Health Information Exchange for LTPAC

Patient documentation is often scattered across healthcare systems: a diagnosis here, a newly prescribed medication there, and test results in three different places. Unfortunately, electronic medical records (EMR) often don’t transfer efficiently across healthcare entities—if they transfer at all. This inability to easily share important data can cause healthcare information silos.

Read Article

What Risk-Based Payment Models Mean for You - APM

Risk-based payment models aim to shift the basis of Medicare reimbursement rates from volume to value, but two different kinds exist. Here's a breakdown of advanced payment models and how ChartPath can help.

Read Article

What Risk-Based Payment Models Mean for You – MIPS

Risk-based payment models aim to shift the basis of Medicare reimbursement rates from volume to value, but two different kinds exist. Here's a breakdown of MIPS and how ChartPath can help either way.

Read Article

Goodbye COVID Free Pass, Hello MIPS Exceptions

The Merit-based Incentive Payment System (MIPS) free pass may not return in 2022. The Centers for Medicare & Medicaid Services (CMS) exempted many clinicians from MIPS reporting in 2020 and 2021 due toCOVID-19. But most clinicians will have to report their 2022 MIPS data when the window opens in January 2023. However, clinicians can still file for one of two hardship exceptions that simplify the process.

Read Article

What is MIPS, and why is it important?

MIPS can seem like an overwhelming program. The commitment is a yearlong event, the charting burden seems never-ending, and the criteria change every year and seem to grow increasingly harder. On top of that, MIPS participation is mandatory for many clinicians, so even a few missteps can cost a pretty penny.

Read Article

Ready to take control of your LTPAC practice?

Great! Because we can't wait to show you how.
Back to Blog
This is some text inside of a div block.