What does patient leakage cost you?
Every out-of-network referral is revenue that leaves your system. Use your own numbers — every input below is editable — and see the annual total, then what a coordinated in-network scheduling workflow could recover.
Hospitals lose 10–30% of revenue to out-of-network referrals (industry surveys).
Illustrative scenarios, not measured results: the share of missed bookings recovered when coordinators schedule in-network at the point of referral.
Industry estimates for illustration. The blended figure matches the $12,000 average revenue lost per out-of-network referral cited above. Replace any value with your own.
How the math works
Two ways to estimate, one principle: transparent arithmetic from numbers you can check — and replace.
By patient volume
annual loss = patients × period × revenue per lost referral
Start from the referrals your teams cannot book in-network. Day counts multiply by 365, weeks by 52, months by 12. The revenue per lost referral comes from the service-line presets below, or from your own figure.
By physician count
annual loss = physicians × net revenue per physician × leakage share
Start from a number every executive knows. The default $2,380,000 net annual revenue per employed physician is the average reported by hospital CFOs in the Merritt Hawkins / AMN Healthcare 2019 Physician Inpatient/Outpatient Revenue Survey. The leakage share reflects industry surveys that put hospital revenue lost to out-of-network referrals at 10–30%.
Service-line presets
Directional estimates of the downstream revenue attached to one referral: the initial visit plus the imaging, procedures, facility fees, and follow-up care it triggers. Anchored to published ambulatory-surgery net-revenue-per-case benchmarks (orthopedics ≈ $6.4K, cardiovascular ≈ $4.3K) plus typical downstream care. They are starting points, not audited benchmarks — enter your own figure to make the estimate yours.
| Service line | $ / lost referral |
|---|---|
| All service lines (blended) | $12,000 |
| Orthopedics & Spine | $18,000 |
| Cardiology | $15,000 |
| Oncology | $35,000 |
| General Surgery | $11,000 |
| Gastroenterology | $6,500 |
| OB-GYN & Women's Health | $8,500 |
| Primary Care | $4,000 |
What the numbers are — and are not
- Net revenue, not operating margin. Results show the revenue at stake, before your cost structure. Apply your contribution margin for a bottom-line view.
- Recapture scenarios are illustrative. The 30/50/70% options model outcomes; they are not measured client results.
- Deliberately conservative. The physician-revenue default is from 2019 and hospital prices have risen since. The leakage share also applies to revenue your physicians already generate, which itself reflects leakage already lost.
- Your numbers beat ours. Every load-bearing value is editable in the calculator. In a demo, we build this with your data.
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