Original ArticlesMedicare Patient Referral Networks to Female Pelvic Medicine and Reconstructive Surgeons Across the United StatesMuffly, Tyler M. MD∗; Gonzalez, Javier MD†; Khorshid, Arian BS†; Hajagos, Janos PhD‡; Kropat, Georg PhD§Author Information From the ∗Denver Health and Hospital Authority, Denver †University of Colorado School of Medicine, Aurora, Colorado ‡Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York §Research & Consulting Ltd., London, England. Correspondence: Tyler M. Muffly, MD, Denver Health and Hospital Authority, 777 Bannock Street MC0660, Denver, CO 80204. E-mail: [email protected]. This article published online ahead of print on July 2, 2019. The authors have declared they have no conflicts of interest. This was presented as an oral poster at the 38th Annual Scientific Meeting of the American Urogynecologic Society, October 5–8, 2017, Providence, Rhode Island. Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.fpmrs.net). Female Pelvic Medicine & Reconstructive Surgery: February 2021 - Volume 27 - Issue 2 - p 126-130 doi: 10.1097/SPV.0000000000000751 Buy SDC Metrics AbstractIn Brief Objective The source of urogynecology patient referrals remains poorly understood. We used novel methods to identify referral networks to female pelvic medicine and reconstructive surgeons (FPMRS) and to determine factors associated with physician connections. Methods A retrospective analysis of Centers for Medicare and Medicaid Services data with physician sharing relationships spanning 180 days during 2015 was performed. All patients studied were Medicare beneficiaries. Provider patient-sharing networks were modeled using social network analytics. To visualize the resulting flow of patients from referring providers to FPMRS, we encoded the node and edge data and mapped the data to a map of the United States. Results We studied 206,568 Medicare beneficiaries who were seen by 618 different board-certified FPMRS. Internal medicine physicians followed by nurse practitioners referred the most patients to FPMRS. Over half of referrals were made locally, with patients traveling less than 5 miles from the referring provider to the female pelvic surgeon. The median number of incoming Medicare patient referrals per FPMRS provider was 15 (interquartile range, 12–20) over a 6-month period. The high modularity of the referral network indicates that most providers refer their patients to a few female pelvic surgeons. Conclusions Medicare patient referrals to FPMRS are primarily and proportionally the highest from local internal medicine physicians. Proportionally, internal medicine physicians refer the most Medicare patients to female pelvic medicine and reconstructive surgeons of any specialty. Copyright © 2019 American Urogynecologic Society. All rights reserved.