Partnering with Community Resources for Better Outcomes

Partnering with Community-Based Organizations (CBOs) for better health outcomes is no longer just a good idea—it’s becoming a vital part of successful healthcare delivery. Healthcare organizations across the country are seeing that medical treatments alone aren't enough to keep people healthy. That's because many health challenges come from what are called “social determinants of health”—things like access to food, housing, transportation, and social support.

So, what’s the best way to tackle these challenges? One powerful solution is to work hand-in-hand with CBOs. These groups already know their communities inside and out. They offer meals to seniors, shelter to families, transportation for those without cars, and more. By treating CBOs not just as helpers but as specialist partners, tracking results together, building trust regularly, and speeding up emergency referrals, healthcare providers can dramatically improve patient outcomes. Let’s explore how.

Why Partner With Community-Based Organizations?

Community-Based Organizations are experts on the ground. They know what people struggle with every day—whether it’s finding healthy food, getting to doctor’s appointments, or having a safe place to live. When healthcare systems partner with CBOs, they can help meet these basic needs, which often keeps people healthier in the long run.

These partnerships focus on:

Addressing root causes of poor health, not just symptoms
Preventing avoidable emergency room visits or hospital readmissions
Supporting person-centered care that respects community culture and needs

According to the Center for Health Care Strategies, integrating CBOs into healthcare planning leads to stronger care coordination and better health for the whole community. That’s a win-win.

Treating CBOs as Specialized Partners (400–500 words)

When you visit a cardiologist for a heart issue or a neurologist for migraines, you're seeing a specialist. Well, CBOs should get that same level of recognition. After all, they specialize in addressing social needs—like housing, food insecurity, and transportation—that most doctors don't manage.

According to the report by the Aging and Disability Business Institute, hospitals and insurers that treat CBOs as key partners, not just service providers, build lasting, scalable health programs.

Let’s look at how it works:

Specialist Role	CBO Equivalent
Cardiologist (heart doctor)	Food bank (nutrition support)
Physical therapist	Transportation service provider
Respiratory therapist	Housing assistance agency

Example in Action

Blue Shield of California Promise Health Plan worked with First 5 LA to improve pregnancy outcomes. Instead of creating new services from scratch, they leaned on First 5 LA’s home visitation programs—already trusted by the community. This helped expectant mothers get medical and emotional support without confusing paperwork or service overlaps (Aging and Disability Business Institute, 2023).

This approach honors what each group brings to the table:

Healthcare providers manage diagnoses and treatment
CBOs handle social care and ongoing community support

When recognized as equal experts, CBOs contribute more dynamically, feel valued, and step into a true partnership role—not just a support one.

Tracking Outcomes and Sharing Metrics (400–500 words)

Partnerships work best when everyone knows what’s working—and what’s not. That's where data comes in.

According to a report from Nonprofit Finance Fund and the Center for Health Care Strategies, solid partnerships require shared goals and data-driven decisions. Healthcare providers can track things like hospital admissions or prescription use. CBOs can measure the number of food deliveries, safe housing secured, or support group visits completed.

Together, they can build shared dashboards to:

Monitor program performance
Adjust services as needed
Demonstrate real impact to funders and policymakers

Joint Metric Examples

Metric	Healthcare Input	CBO Input
Emergency room visits	Yes	NA
Missed medical appointments	Yes	Yes (transport issues)
Housing stability post-discharge	NA	Yes
Diabetes control (A1C levels)	Yes	Yes (nutrition support)
Program satisfaction scores	Yes	Yes

A great example is 2-1-1 San Diego’s Community Information Exchange (CIE). This connected platform lets various providers—from mental health professionals to food pantries—share information safely and instantly. It allows real-time tracking of outcomes, making referrals smoother and care more effective (CHCS, 2020).

This data magic doesn’t just help patients—it guides budgeting, targets urgent needs, and helps secure more funding from government and private foundations.

Building Trust Through Regular Engagement (400–500 words)

Partnerships thrive on trust, and trust doesn’t happen overnight. It comes from face-to-face connection, transparency, and consistency. One great way to build that? Good old-fashioned table talk—like quarterly lunches and roundtable chats.

In healthcare settings, quarterly meetings keep everyone updated on new programs, changing needs, or unresolved issues. But don’t worry—it’s not just about business. Adding a meal or a casual chat helps form real bonds and opens the door for honest feedback.

Research on the Sustainable Emergency Referral Care (SERC) project in Ghana proves that ongoing community engagement builds trust and cultural alignment, both key for effective referrals. Community leaders weren't just consulted—they were part of the solution.

How to Build Trust with CBOs

Host quarterly lunch-and-learns
Share success stories and challenges openly
Rotate meeting hosts between healthcare and CBO locations
Co-create program goals and grant submissions

One standout U.S. example is Hunger Free Colorado’s collaborative model. Healthcare systems worked with them to develop screening tools for food insecurity. Frequent check-ins meant both sides could tweak processes fast, learn from each other, and celebrate wins together (CHCS, 2020).

Building trust isn’t just nice—it’s strategic. It leads to faster referrals, better teamwork, and reduced service duplication.

Speeding Emergency Referrals Through Partnership (400–500 words)

Healthcare’s most stressful moments often happen during emergencies. So, fast referrals between hospitals and CBOs are critical. But without planning, communication delays or paperwork can keep patients waiting for essential help.

That’s where lessons from the SERC Project in Ghana shine. SERC built a model that allotted transportation costs, trained community drivers, and adapted referral processes to local customs. The result? Quicker medical help for critically ill patients.

In the U.S., similar principles apply:

Key Strategies for Faster Referrals

Clear Protocols: Document steps so everyone—from doctors to social workers—knows their role.
Smart Tech: Use platforms like 2-1-1 CIE to trigger automatic alerts when a high-risk patient enters the system.
Emergency Funds: Have a budget line ready for transportation or housing needs, so patients don’t fall through the cracks.
Live Contact Channels: Keep direct numbers or messaging tools handy to avoid emailing into the void.

An example from Portland is Project Access NOW. It connects recently discharged hospital patients directly to housing, food, and follow-up care via CBOs. Their secret? A pre-set referral network, shared data, and trust between all partners (NFF & CHCS, 2020).

Speed matters. Every day saved strengthens recovery chances and reduces healthcare costs.

Conclusion: The Future Is Collaborative

Healthcare doesn’t happen only in hospitals. It happens at kitchen tables, in food lines, in community centers, and on bus routes. That’s why partnering with Community-Based Organizations for better health outcomes isn’t just a smart strategy—it’s a necessary one.

By:

Treating CBOs like specialty providers
Tracking and sharing meaningful metrics
Making time for regular relationship-building
Streamlining emergency referral systems

…we create systems of care that actually care—deeply, personally, collectively.

Set up to support the whole person, not just their symptoms. Backed by metrics, built on trust, and rooted in community voices.

The future of health is here—and it’s connected.

FAQs

1. What is a Community-Based Organization (CBO)?

A CBO is a nonprofit or grassroots group that delivers resources and services within local neighborhoods. They may offer food, housing, mental health support, or transportation.

2. Why should healthcare systems partner with CBOs?

CBOs understand the community’s needs better than most and often bridge the gap between medical care and daily life. This leads