The Right Way to Handle Patient Referrals

By The Fix staff 02/28/18

As the UK grapples with a patient brokering scandal, one recovery agency wants to find an ethical approach to matching clients and treatment centers.

A doctor and patient shaking hands

You have reached rock bottom, and are finally ready to ask for help. You pick up the phone to call an organization that you believe can get you into the right treatment facility, without realizing that organization is actually making a profit for sending you to a particular treatment facility.

This practice, known as patient brokering, is illegal in the United States. However, it recently made headlines in the United Kingdom, where Google was found to be profiting off ads from patient brokers, who in turn made thousands of British pounds each time they send a client to a particular rehab clinic.

“Profiting from referrals hurts the drug and alcohol treatment industry,” says Christopher Yiannakou, the director of Serenity Health, a U.K. organization that connects patients with drug and alcohol rehab services. Yiannakou says that although Serenity Health does refer patients to rehab and detox programs, clients are matched based on their needs, rather than an anticipated kickback from the program that they go to.

“We do a full assessment and place clients into the right treatment center, not like the (brokers) who go for the highest bidders,” he says.

Although the practice of referring clients to rehabs has developed a bad reputation, Yiannakou says it is possible to do client referrals ethically.

“Not every alcohol rehab and drug rehab company can be painted with the same brush stroke, including the referral agents,” he said.

Fenella Price, sales and marketing director for Serenity Health and Substance Misuse, explains that ethical referral agents are focused on helping people find the right treatment center, rather than on turning a profit.

"We were saddened to hear that Google has been profiting from the most vulnerable in our society and want to make it very clear that this is not standard practice across the board,” she said. “We do not make money out of people seeking help for their addictions, but instead look to help and support them to full recovery."

However, unethical brokers have been grabbing the headlines most recently. In the U.K. it has been commonplace for brokers to get a percentage of the cost of a client’s treatment. An unscrupulous broker can pocket up to 40 percent of what a patient is paying, leaving the clinic only 60 percent of the so-called cost of care to deliver recovery services.

“How can a clinic give full benefit to rehab clinic clients when it receives only 60 percent of the fees? This is affecting clients’ treatment,” Yiannakou says.

Some treatment programs have increased their fees in response to the practice of paying brokers, which leaves more people unable to access treatment due to the cost, Yiannakou says.

“There are some things in life more important than profit, and maintaining public health is one of them,” he says.

To try to address the problem of brokers making excessive money off people seeking treatment, Yiannakou has called for the creation of a National Agency for Clinic Addiction Referrals. He hopes that this agency can work with treatment professionals to set standards for what is and is not acceptable when it comes to profiting off patient referrals. One policy that he believes would work is assigning a set percentage that brokers are paid for referrals across the industry.

“This would make it more fair for clinics and increase the focus on the client being put in the right rehab clinic because there's no high fees to gain,” he said.

Although patient brokering has been banned in the United States, Yiannakou doesn’t believe that the U.K. government is ready to ban brokering, or that the healthcare system in the U.K. is ready to remove brokering entirely.

“This problem will not go away,” he said. “Clinics need clients, and broker agencies tend to market themselves better than clinics, so they attract more clients. Thats why a nonprofit, nongovernmental organization needs to be set up to safeguard the clients entering any rehab clinic.”

For more information, visit Serenity Health or follow them on Twitter.

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