Referral Leakage Calculator

Find how many referred patients never reach a first infusion, which step loses the most, and what it costs.

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Your referrals

New patient referrals received, before any screening.

Average infusions a patient who starts gets in a year.

Drug and administration payment, less drug and supply cost.

Where referrals drop out

Each step loses a share of the referrals still left after the step before it.

Referrals never reached, or missing records that stall the file.

Coverage problems or costs the patient declines.

Denied, abandoned, or sent elsewhere while waiting.

Approved patients who never sit in a chair.

Example values. Replace them with yours.

68.5% of referrals reach a first treatment. 151 patients lost a year, $483,960 margin at stake.

Margin at stake a year

$483,960

from 151 referred patients who never start

Referrals a year
480
Reach a first treatment
329 (68.5%)
Patients lost a year
151

Patients lost a year, by step

  • Intake and first contact38
  • Benefits investigation44
  • Prior authorization48
  • Scheduling the first visit21

Biggest leak: Prior authorization. Start there.

A planning estimate, not a forecast. It counts one year of treatment for each lost patient. Free, and nothing you enter is sent anywhere.

How to use it
  1. Enter your new referrals a month, treatments per patient a year, and net margin per treatment.
  2. Enter the share of referrals lost at intake, benefits investigation, prior authorization, and scheduling.
  3. Read how many patients reach a first infusion, the margin at stake a year, and which step leaks the most.
How the numbers work
  • Referrals a year = referrals a month × 12
  • Lost at each step = referrals still left at that step × that step's loss rate
  • Reach a first treatment = referrals a year × (1 − intake) × (1 − benefits) × (1 − authorization) × (1 − scheduling)
  • Patients lost = referrals a year − patients who reach a first treatment
  • Margin at stake = patients lost × treatments a year × margin per treatment ($3,200 per patient with your inputs)

The losses compound rather than add. With the example values, 8%, 10%, 12%, and 6% losses leave 0.92 × 0.90 × 0.88 × 0.94 = 68.5% of referrals, not 64%.

Before you trust the result
  • Not every lost referral was yours to keep. Some patients are not candidates, change therapy, or go to a site their plan requires. Count the ones you could have kept.
  • Lost patients do not all stay a full year. Patients stop, switch, or start late. The margin here is a ceiling for one year, not lifetime value.
  • Measure each step from dates, not memory. Referral received, benefits checked, authorization approved, and first visit each need a date so you can see where files stall.
Questions

What is referral leakage at an infusion center?

Referral leakage is the share of referred patients who never reach a first infusion with you. They drop out at intake, benefits investigation, prior authorization, or scheduling, and the treatment margin goes with them.

How do you calculate referral leakage?

Start with referrals a year, then apply each step's loss rate to the referrals still left after the step before it. Patients lost is referrals a year minus patients who reach a first treatment, and margin at stake is patients lost times treatments a year times margin per treatment.

Why do the step losses multiply instead of add?

Each step can only lose referrals that made it through the steps before it. With the example values, losses of 8%, 10%, 12%, and 6% leave 68.5% of referrals, not 64%.

Which step usually loses the most referrals?

It varies by center, payer mix, and drug, so there is no single answer. Record a date for referral received, benefits checked, authorization approved, and first visit, and the gaps show you where files stall. The calculator names the biggest leak for your inputs.

Is the margin at stake the full value of a lost patient?

No. It counts one year of treatment for each lost patient, and some of those patients would have stopped, switched, or started late. Treat it as a one-year ceiling, not lifetime value.

Where the definitions come from

Referral conversion rate, referral-to-first-treatment time, and prior authorization turnaround are defined in the infusion center KPI glossary. If you run on WeInfuse, the WeInfuse reporting guide covers which records hold those dates.

Infusion center KPI glossaryWeInfuse reporting guideTalk to Greyfield Data

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