Session 3: Identifying Community Resources, Making Referrals to Community Based Organizations, and Evaluating Closed Loop Referral Platforms

After you have successfully identified social needs among your patients the next step is to identify reliable, high quality community resources to address the needs. Ideally, your ACO will not only refer to community-based organization but know the status and outcome of those referrals. Closed loop community referral systems are information networks intended to help provider groups facilitate, track and follow-up on community service referrals. Numerous companies such as Aunt Bertha, UniteUS, and NowPow have been established to help identify resources and make referrals. This session will address strategies for identifying community resources, provider an overview of features available on referral platforms, and discuss considerations for when and how to leverage these platforms. Participants will discuss how to determine whether they need to use a platform and  what features would be most helpful to their organizations. We will also discuss strategies to facilitate convergence around a single platform within a community.