To coordinate patient care effectively, primary care providers must not only identify resources and make appropriate referrals, but they must also communicate with other service providers, help patients access specialty services, monitor the referral and consultation processes, and integrate findings from referrals into the care they provide. Studies have shown, however, that practices lack the tools and training to implement and maintain high-quality referral processes in coordinating patient care. Directed by a national leader in primary care practice improvement, this project will develop consensus standards for the provision of referral services and test strategies to change referral practice. One of the key products will be a training manual that state agencies, payers, and health care organizations can use to help primary care practices achieve high performance for this critical area of care.