Just a few short years ago, the largest barrier to referral growth was the perception that hospital-based agencies were receiving all of their hospital’s referrals. Small and large companies alike were intimidated by this monopolistic approach that they felt they could not possibly overcome. The irony is that Medicare claims data tells an entirely different story. Many hospital-based agencies receive below 60% of their parent hospital’s home health discharges. A good number of those agencies are convinced that being part of the hospital provides them security, when it most certainly does not.