Californians who rely on community clinics and public hospitals for their health care often encounter numerous obstacles in obtaining referrals to medical specialists. Since such patients are typically either uninsured or enrolled in public programs, providers who see them can expect little or no reimbursement. Communication between physicians can be poor, and in some areas of the state, the supply of specialty-care providers is quite limited.

Nonetheless, opportunities exist for making better use of specialty networks through the innovative application of provider resources, technology, and new models of care. Identifying workable strategies requires a thorough understanding of the clinical scenarios that lead to referrals within individual specialties, and the specific types of services that are requested.

This white paper presents the insights gleaned from a series of interviews with experienced primary care providers at community and public hospital clinics. It identifies specific challenges, offers ideas about how to overcome them, and attempts to construct a framework within which the provider community can explore better ways to obtain specialty referrals for patients in the safety net.

The complete paper is available under Document Downloads.

Additional reading on this topic is available through the External Links below.