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Monitoring Follow Up After Behavioral Health Hospitalization

UPMC Health Plan Behavioral Health Services monitors the rate at which members receive timely follow-up outpatient treatment after discharge from psychiatric hospitalizations. We monitor the percentage of members who attend an outpatient appointment within 7 and 30 days after discharge.

To monitor these rates, UPMC Health Plan Behavioral Health Services uses a standard national methodology contained in the Healthcare Effectiveness Data and Information Set (HEDIS).  

Our ambulatory 7-day follow-up rate for calendar year 2007 is 60.25%, which surpasses the national HEDIS average of 56.7%.  Similarly, our ambulatory 30-day rate of 82.03% exceeds the national average, which is 75.92%.
Barriers identified in regards to the member’s ability to keep follow-up appointments may include:

• Members seeing their primary care physician instead of a behavioral health professional for follow-up after discharge
• Members not being aware of the importance of aftercare
• Practitioners not adequately assessing a member's specific barriers to follow-up, such as transportation or child care; this poor discharge planning can result in delays with follow-up treatment

UPMC Health Plan Behavioral Health Services has implemented many interventions to overcome the aforementioned barriers. Interventions include:

• Outreach to members and their aftercare practitioner using motivational interviewing techniques to encourage members to attend follow-up treatments and problem solving with members if appointments are not kept
• Extending active problem solving training to Care Managers
• Annual distribution of reports to high-volume inpatient providers to inform them of their follow-up rates as compared to the network's average
• Reviewing inpatient records for documentation of member education on the importance of follow-up care
• Publication of articles related to the importance of follow-up care
• Encouraging providers to contact Care Managers for assistance in the event a barrier arises in discharge planning

UPMC Health Plan Behavioral Health Services will continue to monitor the follow-up rate after behavioral health hospitalizations and will develop additional interventions to improve these rates.

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