FQHCs: Closing Referral Loops Doesn’t Have to Be Difficult

If you’re an administrator at an FQHC, you know closing referral loops can be burdensome. But you also understand how essential it is to close those loops — it’s essential to both your patients’ overall care and to your facility’s value and outcome-based incentives, for example, Meaningful Use (MU) credits.

When your health center refers a patient, your ability to track that referral’s progress often depends primarily on the referred specialist or some sort of third-party reporting. Unfortunately, however, these options may fall short of supplying referring providers with the information they need.

Since closing referral loops is vital to ensuring proper continuity of care and better reimbursement for facilities, it’s time to update the status quo and implement a simple yet effective solution.

The Pitfalls of Open Referral Loops

The impact of unclosed referral loops on Meaningful Use credits and related reimbursements is a major consideration.

More critically, closed referral loops are critical for better care coordination and improved patient outcomes.

You refer patients for a reason — likely an important one. The results of that referral may be critical to a patient’s health outcome. As their primary care provider, you need to know:

• Did the patient schedule and keep the referral appointment?
• Did they receive the treatment they needed?
• What were the results?
• Do they require follow-up care?

You need a full picture of what happened under a specialist’s care, so you can help determine what should come next in the care plan or consider an alternate approach or provider, if needed.

Be Proactive With Referrals: 4 Simple Steps

Many health centers take a fairly passive position concerning their referrals, waiting for updates from the specialist or third parties, such as referral prescription capture programs.

To complement your existing processes, we recommend taking a proactive approach to closing the referral loop. The effort is minimal yet worthwhile, and it needn’t be difficult. Consider implementing these simple steps:

• Step 1: Notify the patient of their referral via an on-demand SMS or email message from your staff. Although your medical staff likely mentioned the referral to the patient already, this proactive outreach confirms to the patient that the referral is indeed happening. It can also clarify the next steps.
  
• Step 2: Two weeks later, send a follow-up messageinquiring about the status of the patient’s referral.Include a form to gather their input on whether they scheduled and kept the referral appointment — or if not, why. Also, ask about the results: Was medication prescribed? Was a medical procedure scheduled or recommended?
  
  Use a customizable platform that allows you to tailor your form’s questions and responses so you get exactly the information you need. Since your patients already know and trust you as their primary care provider, they’ll likely respond happily and promptly. Once you’ve assessed their input, you may also find it useful to contact the referred specialist for further detail.
  
• Step 3: Let your patient’s responses guide your next steps. Their answers will give you the information you need to provide further support as needed.
  
  For example, if a patient can’t book their referral appointment due to financial hardship, a care coordinator can seek a more cost-effective alternative for them. Or, if a patient schedules a procedure with the referred doctor, a care coordinator can follow up with them — and perhaps with the specialist — to manage the next steps.
  
• Step 4: Organize your team’s referral tasks and communications. To help streamline the management of patient responses, Simple Interact provides a Shared Inbox to simplify your team’s management of the referral process. The Inbox allows us to automatically file patient responses under custom categories created for you based on common responses. This helps you automatically assign relevant tasks to the appropriate staff members.
  
  In the above example, you might set the Shared Inbox to alert a specific care coordinator if a patient response is filed under the Financial Hardship category. The team member receives an automatic notification and can begin searching for more financially reasonable care. They can also append notes, activate 2-way texting, or assign activity to others as needed.

Essentially, you’re proactively reaching out to patients for updates at different touchpoints, while relying on your automated platform as a decision support system to effectively track important details and data.

Keep It Simple but Effective

Closing referral loops ensures the best possible care coordination for FQHC patients. At Simple Interact, we believe the four steps above are the least complex and most effective way to help you consistently and comprehensively gather and report salient details on referrals.

The more your providers know about how each referral went, the more successful follow-up support you’ll provide — and the better you’ll comply with Meaningful Use reporting standards fundamental to your reimbursements.

Contact us for more advice on closing referral loops, and to see how the Shared Inbox function — part of Simple Interact’s core framework — can help you.