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Fidelis Care serves more than 1.7 million children and adults of all ages, making us one of the largest health insurance plans in New York State. We were founded on the belief that all New Yorkers should have access to quality, affordable health insurance, and our mission to help others informs everything that we do. 

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The Critical Role of Care Coordination Between PCPs and Specialists
2025/9/29 • Posted by Provider Relations in Provider News, Provider Quality

In today’s healthcare landscape, effective coordination between primary care providers (PCPs) and specialists is essential for delivering safe, timely, and patient-centered care. When providers collaborate, patients benefit from accurate diagnoses, appropriate treatments, and a smoother care experience.

Why It Matters

PCPs manage preventive care and chronic conditions, serving as the first point of contact for members. When specialized care is needed, such as for heart disease or skin conditions, specialists become key partners. Without coordination, patients may face delays, conflicting advice, medication errors, and increased healthcare costs.

Referrals: A Vital Link

Referrals are more than administrative steps; they ensure patients receive the right care at the right time. A strong referral process provides specialists with relevant medical history, clarifies the reason for referral, and supports continuity of care.

Communication Is Key

Coordination doesn’t end with a referral. Ongoing communication between PCPs and specialists is critical. Sharing updates, aligning on treatment plans, and using shared electronic health records (EHRs) helps create a unified care approach.

Fostering Collaboration

Healthcare organizations can strengthen coordination by:

  • Using integrated care models and shared EHRs
  • Establishing clear referral and follow-up protocols
  • Encouraging interdisciplinary collaboration
  • Promoting patient-centered communication

Ultimately, coordinated care puts the patient at the center of a connected healthcare ecosystem. These efforts help lead to better outcomes, improved satisfaction, and more efficient care delivery for members.

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