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.