Rural referrals represent significant revenue for managed care organizations.
A study was conducted to evaluate the potential economic effect of referrals on managed care organizations by rural physicians to providers outside a rural county. Patient referral records and associated financial data were gathered for a three-month period. Referrals by this group of rural primary care physicians to specialists outside their rural county resulted in an average of approximately $1,100 of collected revenues per episode of care and in an average of more than $2,600 of expected payments per hospital inpatient stay. The results from this study can serve as a preliminary guide for managed care providers as they structure their services for rural settings.
Parsons
R J
RJ
Marriott School, Brigham Young University, Provo, UT, USA.
Bateman
K A
KA
D017050:Episode of Care; D005194:Family Practice / Q000191:economics / Q000458:organization & administration*; D005249:Fees and Charges; D007182:Income / Q000706:statistics & numerical data; D008329:Managed Care Programs / Q000191:economics* / Q000706:statistics & numerical data; D010821:Physicians, Family / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000191:economics* / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000191:economics / Q000706:statistics & numerical data*; D019035:Rural Health Services / Q000191:economics*; D014481:United States