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Continuity and Coordination of Care

Community Care routinely monitors the coordination of a member’s care and exchange of clinical information among practitioners.  We strongly encourage practitioners to coordinate care with other practitioners who are seeing the same member.  Coordination is important for member safety, to avoid duplicate assessments, procedures or testing and to improve treatment outcomes.

The 2006 goal for written evidence of exchange of information among behavioral health practitioners ranged from 80% - 100% in our various counties.  In 2006, the rate across our counties ranged from 83% - 94%, meaning that when it was appropriate to do so, providers exchanged information and documented that they did so an average of 87% of the time.  For 3rd Quarter 2006, the rate for one level of care in Lackawanna, Luzerne, Susquehanna and Wyoming Counties was 56% with a goal of 80%.

For evidence of exchange of information from behavioral health clinicians to PCPs, the goal for 2006 for our counties ranged from 80% - 100%.  The 2006 rate across our counties ranged from 42% - 53%, with an average of 48%.  For 3rd Quarter 2006, the rate for one level of care in Lackawanna, Luzerne, Susquehanna and Wyoming Counties was 15% with a goal of 80%.  Exchange of information is more likely to occur among behavioral health practitioners than it is between behavioral health providers and PCPs in all of our counties. 

To encourage exchange of information, Community Care has done the following:

• Requested Corrective Action Plans from providers when rates were below the goal.
• Included articles in our provider newsletter regarding the importance of coordinating care.
• Posted a sample exchange of information letter on our website.
• Sent all HealthChoices members in all of our counties a “Mind Your Health” flyer during Mental Health Month that included the connection between physical and behavioral health as well as how important it is that their doctors are talking to each other.  This flyer was also posted on our website for the month of May.

If you have found other techniques that are effective in promoting coordination of care among behavioral health practitioners and between behavioral health practitioners and PCPs, we would appreciate hearing from you.  Please call us at 1-888-251-2224 with your ideas and comments.

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