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Provider Benchmarking

Every year, UPMC Health Plan Behavioral Health Services sends benchmarking reports to our providers to let them know how they are doing in certain areas related to the services they provide to members. The reports include the network average and goals, when possible.

The benchmarking reports look at inpatient mental health services for the UPMC for Life (Medicare) population. The providers who offer these services are rated on how many members are readmitted to the hospital within 30 days of discharge, how many members have a follow up appointment within 7 and 30 days of being discharged from the hospital, and the average number of days for members to have a follow-up appointment after discharge.

UPMC Health Plan Behavioral Health Services measures these items because we believe that members who have timely follow-up appointments after discharge have a better chance of recovery.

If a provider's rate for any indicator was significantly different than the established quality benchmark, that provider was asked to submit a written assessment as to why the rate was so different and interventions they could implement so that their rate for the following year could improve.

For more information on provider benchmarking, please call UPMC Health Plan Behavioral Health Services at 1-888-251-0083 Monday through Friday, 8:00 a.m. to 5:00 p.m. (TTY Line: 1-877-877-3580) and ask to speak to a Quality Representative.

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