Integrate social care. Reduce avoidable admissions. Deliver whole person care.
Bridge the gap between clinical care and community resources
To deliver true whole person care, your care teams need visibility outside the walls of the health system. Our digital infrastructure connects your staff and patients to a highly curated, nationwide network of community-based organizations. Find, refer, and track outcomes for patients experiencing food insecurity, housing instability, and other social barriers—all in one unified platform.
Enable the digital safety net for your patients and see measurable impact.
100,000+ patients assessed in 6 months via EHR integration
66% increase in patient trust
16% reduction in avoidable hospitalizations
The nation’s largest and most engaged network of programs, ready to activate for your organization.
Before
Static Network Bottlenecks
Platforms that force community organizations into closed, contracted networks artificially limit care access and stifle adoption. Relying on these static, limited, or restricted creates an operational blind spot. They cannot scale, preventing you from proving cost avoidance, tracking utilization, or reducing uncompensated care.
After
A Connected Ecosystem
Most platforms just list programs. We power the dynamic, customizable infrastructure that community organizations actually use. With over 960,000 verified locations, every interaction fuels our network effect. Programs update capacity, navigators close loops, and you gain real-time visibility into which CBOs are actively resolving health-related social needs (HRSNs).
The #1 rated SDoH network. 5 years running.
How to integrate social care without disrupting clinical workflows
Clinicians reject tools that require leaving their primary workspace. We use SMART on FHIR to embed SDoH screening, assessments, and program recommendations directly inside your EHR.
1
Screen in the EHR
Use Single Sign-On (SSO) to capture needs directly in the patient record, building a secure, longitudinal social care record.
2
Refer with one click
Eliminate manual tracking. Care teams generate pre-curated resources and send electronic referrals instantly.
3
Increase capacity
Automate the referral process to reduce administrative burnout and free your care teams to focus entirely on direct patient care.
Seamlessly integrated with
and more
Epic is a registered trademark of Epic Systems Corporation.
Purpose-built SDoH solutions for every care setting
Our infrastructure adapts seamlessly to your operational model and goals.
Inpatient Health: Hospitals & Health Systems
Goal: Improve quality and reduce length-of-stay.
Advantage: Match patients to verified post-acute resources directly from the EHR to avoid readmission penalties and identify community needs for CHNA reporting.
Outpatient Health: Ambulatory and Primary Care
Goal: Prevent chronic disease and promote health.
Advantage: Identify needs and automate patient recommendations to verified programs in seconds.
Accountable Care Organizations (ACOs)
Goal: Manage total cost of care risk.
Advantage: Gain network-wide visibility to prove which community investments actually reduce medical costs and drive shared savings.
Federally Qualified Health Centers (FQHCs)
Goal: Scale preventive care without adding headcount.
Advantage: Automate closed-loop referrals so staff can focus on clinical care while easily generating audit-ready HRSA compliance data.
Building trust for more than 15 years with partners nationwide
The SDoH compliance & reporting checklist
Demonstrating your impact on community health shouldn’t require manual data aggregation. Replace vulnerable spreadsheets with an enterprise-grade platform designed to automate your reporting and protect patient data.
Manage patient consent: Capture compliant, patient-directed, per-referral consent to ensure secure data sharing between clinical teams and community partners.
Demonstrate impact: Combine social needs screening, referral, and service data with clinical data to track activities impacting patient outcomes.
Fulfill mandates: Easily support Joint Commission requirements and Community Health Needs Assessments (CHNAs).
“As doctors, we know that too often our patients are struggling with making ends meet, and that is a particularly frustrating barrier to getting or staying healthy. This new referral platform and patient-facing website for staff is a powerful new tool in our toolbox to help our patients connect with community services and resources.”