Health Promotion CouncilA PHMC Affiliate

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Referral Linkages

Increasing communication between the clinical setting and community-based programs is essential to ensuring the effective utilization of diabetes management and prevention resources. By increasing communications, referrals, and inter-connectivity, those with and at risk for diabetes will have better access to health care resources.

Medicaid Managed Care Organization Workgroup  

PA CCI has convened a work group of Medicaid Managed Care Organizations (MCOs) to address the issues related to increasing utilization of DPP, DSME, and chronic disease self-management programs (lifestyle change programs). The MCOs established high priority strategies aimed at overcoming the barriers and challenges for providers to refer patients for DSME. These strategies are supported by evidence-based research and best practices identified through an exhaustive literature search.  The first priority is improving provider education and awareness of the availability, benefits, and referral procedures of DSME programs.


Closing the Referral Loop

PA CCI in partnership with the Pennsylvania Department of Health, Quality Insights of Pennsylvania (QIP), Pennsylvania’s Quality Improvement Network (QIN) for the CDC, and other multi-sector partners are developing a replicable, sustainable model to increase and improve community-clinical linkages in order to “close the referral loop” by improving communication systems between clinicians and community-based chronic disease self-management (CDSM) programs, such as CDC Recognized DPP, and ADA recognized and AADE accredited DSME Programs.