What network leakage is

The originating provider never finds out. In its systems the referral is still open, the patient shows no care delivered and the service reads as not performed, while the exam report sits filed at another centre, under another provider's name.

How do you tell leakage from a care gap?

By what happened to the patient. In leakage the care happened outside; in a care gap it happened nowhere. Both look the same from the inside, so they get counted together and attacked with a single campaign that only works on one of them.

Leakage is decided in the first hours after the consult. The patient walks out of the consult with the order in hand and resolves it wherever they can get an appointment soonest, wherever is closest, or wherever somebody answers the phone. Speed of contact outweighs the brand, and the volumes involved are large: a study of leakage in Medicare accountable care organizations found that in the most specialty-oriented of them, 61% to 72% of specialist visits by their own attributed patients were delivered outside the organization's contracting network.

The two economics read it differently. For a provider paid fee for service it is revenue gone; for one working under capitation it is spending that arrives anyway, with the patient later and in worse shape. Same data point, opposite sides of the street.