SAGES 2026 Annual Meeting Emerging Technology Session

BACKGROUND

In value-based independent physician associations (IPAs), primary care referral patterns directly influence care coordination, access to colorectal cancer services, and system financial performance.

OBJECTIVE
To quantify how PCP referral behavior contributes to out-of-network leakage in colorectal cancer care

METHODS
3 Phase Study design

•Retrospective analysis of screening colonoscopy referrals (n=12,875)
Review of colorectal cancer patient pathways (n=100)
PCP referral behavior survey (n=12)

RESULTS

Figure 1:

In-network vs Out of Network (OON) colonoscopy referrals:

•~30% colonoscopies are done out of network

•Annual leakage ~$2M/yr

Figure 2:

Downstream Patient Leakage from Network

•Only 38% surgery in-network

•Only 21% chemotherapy in-network

•Downstream leakage ~$1M/yr

Figure 3: PCP Survey Findings

A: Limited awareness of financial impact

B: Limited visibility if in network providers

ACTIONABLE SOLUTIONS

•PCP education on downstream impacts
EMR in-network referral prompts
In-network provider visibility tools
Feedback dashboards

SAGES 2026 Annual Meeting Emerging Technology Session

From data to impact: Leveraging referral analytics to improve health system outcomes in cancer care

Poster Presenter

Authors

Affiliations

Part of Topic