How Referral Coordinators Leverage High-Quality Data

During our webinar A New Approach for Employee Healthcare Referrals, panelists discussed how referral coordinators leverage high-quality data and provide a human touch to help employees choose the best providers at the best price.

Marathon Health CMO and webinar series host Shelly Towns spoke with Steve Santangelo, VP of Sales from Garner Health — a data-driven, provider search tool; Pierce Graham-Jones, EVP of Growth and Strategy for Marathon Health; and Caitlin Murray, Member Relations Manager for Marathon Health.

Pierce explained how price in the healthcare industry has no correlation with the quality of care employees receive and how important transparency is for employees to make informed decisions regarding their healthcare. He says that while data is important, employees often distrust the referral information they receive from a website and feel more at ease receiving referral information from someone like their primary care doctor. “They don’t trust a website to tell them where to go for care,” Pierce says. “They want someone they feel comfortable with to help guide them in making decisions about their healthcare.”

In one of the webinar polls, participants were asked if their employees currently have access to a referral service or transparency tool. Almost half responded yes, but their utilization rate was low, while 50% said they didn’t offer a referral service or tool. Only 3% responded yes and the utilization rate was high.

Pierce says there are two factors that play a key role in quality referrals:

A high-touch service from humans gives employees the attention and support they need in their healthcare decisions.
The best possible data on pricing and quality of care to guide better healthcare outcomes and savings.

Steve says Garner Health and Marathon Health’s new partnership was driven by the need to ensure that employees and employers are receiving transparent information about high-quality, low-cost providers. “When we’re looking at providers, we take a granular approach to every decision they make along the patient’s journey and that’s what really differentiates our data from the rest of the market,” Steve says.

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Providing the patient with a high-touch concierge experience is another key component, and Caitlin explained what that process looks like. “We let the patient know as soon as we get their referral that we’re here to help them answer any questions they have about things like insurance. We use the Garner tool to find the best providers in their area while reassuring them that we’ll help them through the referral process.”

Caitlin shared examples of how the referral process can impact outcomes. “We had one employee in his 30s who was experiencing abdominal pain. Our referral coordinator was working with him on getting a referral for a CT scan and it kept getting declined by insurance. This created a lot of stress for the employee because he wanted to know what was causing his pain. Once the referral was finally approved and he got the scan, he found out that his pain was being caused by a tumor and that he had pancreatic cancer.”