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Provider Benchmarking

Every year, Community Care sends benchmarking reports to our providers.  They tell providers how they are doing in certain areas of providing care to members.  The reports also show the individual provider rate, as well as the average scores for each of our counties.  This lets providers see how well they are doing compared to other providers in their area.

The benchmarking reports look at these levels of care:

• Inpatient mental health
• Residential Treatment Facilities (RTF)
• Drug and alcohol rehabilitation
• Family Based Mental Health Services
• Intensive Case Management/Resource Coordination (in the Chester County and Northeast contracts)

The reports tell providers things like:

• The average of how long members are in their care.
• How many members have an outpatient appointment within seven and 30 days after getting out of the hospital.
• How many members go back into the hospital within 30 days after getting out.
• How many complaints and denials the provider received.

The family based reports tell providers how much treatment the family is getting and if an individual or a team delivers that treatment.  It also tells providers how many of the children being treated by their family based teams went into the hospital.  Another thing the family based report tells providers is the number of children with ADHD who have a medication appointment within the first 4 months of starting family based services.

The RTF reports tell providers the number of children who had a follow up appointment within 7 days of their leaving the RTF.  It also tells providers the number of children being treated in their RTF who went into the hospital.

Community Care sends the benchmarking reports to providers once a year.  If you would like more information about our provider benchmarking reports please call us and ask for someone in the Quality Department. 

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