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* 1. Name:

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* 2. Email Address:

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* 3. What are the 3 key strategic areas you are struggling to monitor, achieve and/or track? (Only pick 3)

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* 4. How many different EMRs are used across your ACO?

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* 5. How are referrals handled within your ACO today?

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* 6. How do your providers know who is in the preferred network?

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* 7. Are you tracking out of network referrals and the reasons why?

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* 8. Do you have network expectations or standards for timeliness of routine, urgent and/or emergent referrals? (ie. 2 days for urgent, 7 days for non-urgent)

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* 9. Are you interested in discussing options for improving referral management? 

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