U.S. Patient Referral Management Software Market (2025 - 2030) Size, Share & Trends Analysis Report By Type (Inbound, Outbound), By Deployment Mode (Cloud & Web-based, On-premise), By End-use (Providers, Patients, Payers), And Segment Forecasts

Market Size & Trends

The U.S. patient referral management software market size was estimated at USD 7.13 billion in 2024 and is expected to grow at a CAGR of 16.7% from 2025 to 2030. This growth is attributed to the growing emphasis on enhancing care coordination among healthcare providers, fueled by the shift toward value-based care models. The increasing adoption of healthcare IT and digital platforms has created a favorable environment for the deployment of referral management solutions that streamline workflows and improve patient outcomes. One of the primary concerns among providers is referral leakage, which can result in significant revenue loss; referral software helps mitigate this by ensuring efficient and traceable referral pathways.

In addition, the rising need to improve patient experience through faster specialist access and real-time communication is further accelerating demand. For instance, in October 2024, Boston Eye Group collaborated with Sophrona to enhance its referral process by introducing the Referral Portal, aiming to replace inefficient communication methods with a more transparent and streamlined system.

“We knew we needed to invest time and effort in our referring doctor experience. We implemented the Referral Portal to enhance the relationship with our referring doctors and improve coordination of care. Referral Portal helps our practice advance patient engagement, expand connectivity and automate referral reporting”

-MD, PhD, Boston Eye Group Founder & Medical Director

Regulatory initiatives promoting interoperability and health information exchange are also pushing healthcare systems to adopt integrated solutions. The expanding use of telehealth and virtual care platforms has made it crucial to have seamless referral workflows, especially in remote and underserved areas.

Furthermore, AI-powered analytics and smart routing capabilities are enhancing decision-making and optimizing specialist allocation. These factors, combined with increasing healthcare infrastructure investments and workforce shortages, especially among specialists, are collectively boosting the growth of the U.S. patient referral management software industry.

Case Study & Insights

Case Study: Minimizing Network Leakage and Enhancing Physician-Patient Engagement with an Integrated Referral Management Solution

Solution: As a result, many of Innovaccer’s existing clients have shown interest in a solution that streamlines referral processes, minimizes patient leakage, and enhances both physician and patient experiences. Innovaccer’s Referral Management solution addresses these needs effectively. It is particularly valuable for large provider networks with multiple physicians and a centralized referral team (CRT), as it enables efficient, centralized handling and transmission of all referrals.

Outcome:

Market Concentration & Characteristics

The degree of innovation is high, characterized by rapid advancements in technologies such as artificial intelligence, cloud-based solutions, interoperability, and patient-centric features. Companies are increasingly integrating AI into patient referral systems to automate the referral process, predict patient needs, and prioritize cases based on urgency. For instance, in February 2025, CareCloud, Inc. launched an advanced referral module for its AI-enabled EHR system designed to simplify the referral process for medical providers.

The level of mergers and acquisitions (M&A) activities in the U.S. patient referral management software market is moderate, with a continuous flow of strategic partnerships to expand capabilities and market reach.

TheImpact of regulations on the U.S. market for patient referral management software is medium, as compliance with strict healthcare standards is essential for product development and market entry. Regulatory bodies like the Health Information Privacy and Security Regulations (HIPAA), which set standards for the privacy and security of patient information and patient referral management software, must ensure secure handling, transmitting, and storage of personal health information of patients.

Regional expansion in the patient referral management software market is driven by varying factors across key geographies. In North America, advanced healthcare infrastructure, increasing administrative burden on healthcare providers and strong regulatory frameworks are accelerating growth. Europe is witnessing increasing focus on integrated care and care coordination, strict regulations and data protection laws in Europe, and growing government investments in digital healthcare infrastructure.

Type Insights

The inbound segment held the largest market share of 76.95% in 2024. The inbound referrals are received from multiple sources, such as fax, email, phone, and walk-ins, in a single attempt. For instance, Referral MD software provides features such as incoming referrals, patient engagement tools, and direct patient scheduling. Helping analytical tools provide metrics of the patient’s ongoing process and historical data, which can be re-targeted in containing the patients, improving their satisfaction, and inviting new clients.

The outbound segment is expected to grow significantly over the forecasted period. This growth is driven by the growing need among healthcare providers to ensure continuity of care and reduce patient leakage. As providers aim to maintain patient engagement within their healthcare networks, outbound referral solutions help streamline the process of referring patients to external specialists or facilities while maintaining visibility and control over the referral journey. In addition, advancements in interoperability and integration with EHR systems are making outbound referral solutions more efficient and attractive to health systems and group practices.

Deployment Mode Insights

The cloud and web-based segment dominated the U.S. patient referral management software industry in 2024. Cloud-based solutions provide on-demand self-serving insights, minimal upfront capital investment for hardware, and exceptional capacity flexibility, among others. This sector has witnessed rapid expansion. A database in the cloud is a real-time database that synchronizes data to every connected client. The use of a cloud-based referral platform enables two-way communication among healthcare practitioners and the healthcare community. In January 2024, Novartis Healthcare Philippines partnered with Rizal Medical Center to launch STAHR, a web-based electronic referral solution for hospitals.

The on-premise segment is expected to grow at a steady CAGR over the forecasted period. Many organizations prefer on-premise solutions to maintain direct oversight of patient information, especially in facilities with established IT infrastructure and strict compliance requirements. This deployment model also supports tailored configurations that align with specific workflow needs, making it a preferred choice for larger hospitals and specialty clinics aiming for seamless internal integration and enhanced data governance.

End-use Insights

The providers segment held the largest market share owing to the growing burden of patient referrals. The healthcare providers attend to the majority of patients as they provide the first point of consultation for a range of general and specialized health issues. Therefore, providers hold a large pool of patients for referring to different hospitals and segments. In July 2023, Forcura launched enhanced referral technology designed to improve patient care transitions into home-based care.

On the other hand, the patients’ segment is anticipated to expand at the fastest CAGR over the forecast period. The rising geriatric population and an increase in the rate of chronic illnesses are driving the use of patient referral systems. The patients are evaluated by the healthcare providers on the basis of necessary diagnostic measures, and then they are transferred to specialists depending on the care requirements.

Key U.S. Patient Referral Management Software Company Insights

The companies operating in the U.S. patient referral management software market are focusing on strategic partnerships, collaborations with other organizations, and innovative solutions. The market players are undertaking strategies such as acquisitions, new product launches, joint ventures, agreements, and expansion in other regions to increase their market outreach. For instance, in April 2024, Medsender, a software company in New York, launched an AI-based Referral Processing solution.

Recent Developments

• In October 2024, Care Continuity launched specialty referral optimization, an AI-driven approach that improves the specialist referral process. This product helps health systems and hospitals in prioritizing patients for navigation based on their clinical needs.

“Our Specialty Referral Optimization solution leverages AI and machine learning to not only improve service line throughput for health systems but also enhance patient satisfaction and improve clinical outcomes”.

- Brad Prugh, CEO at Care Continuity

• In June 2024, Intiveo introduced a two-way referral management solution designed specifically for dental practices, enabling seamless sending and receiving of patient referrals within their software platform. This new tool is designed to streamline the referral process by offering secure communication channels, real-time patient tracking, and integrated referral management capabilities.

“We are always looking for ways to allow practices to focus on providing great dental care and our customers have consistently told us that handling referrals is a major pain point for front office staff, with current solutions falling short. In response, we’ve enhanced our referral offering with features that address the entire referral lifecycle that are overall and are designed to improve the referral process, making it faster, clearer, and more convenient for everyone.”

-CEO and co-founder of Intiveo.

U.S. Patient Referral Management Software Market Report Scope

U.S. Patient Referral Management Software Market Report Segmentation

This report forecasts revenue growth at the country level and provides an analysis of the latest industry trends in each of the sub-segments from 2018 to 2030. For this study, Grand View Research has segmented the U.S. patient referral management softwaremarket report based on type, deployment mode, and end-use:

• Type Outlook (Revenue, USD Million, 2018 - 2030)

  • Inbound

  • Outbound

• Deployment Mode Outlook (Revenue, USD Million, 2018 - 2030)

  • Cloud & Web-based

  • On-premise

• End-use Outlook (Revenue, USD Million, 2018 - 2030)

  • Providers

  • Payers

  • Patients

  • Others