Improving Continuity of Care: Success of a Behavioral Health Program

Reich, Leonard; Jaramillo, Beatriz M.; Kaplan, Lisa; Arciniega, Jacqueline; Kolbasovsky, Andrew

doi:10.1111/j.1945-1474.2003.tb01094.x

Cited by 6 publications

(3 citation statements)

References 9 publications

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“…This likely reflects the tendency within a carefully managed HMO system that members with more serious mental health conditions are likely to be connected with outpatient treatment. 13,14 The presence of a depression diagnosis during the index hospitalization was associated with fewer days in the hospital for a mental health condition in the postindex period. This negative association may reflect the high degree of attention paid to the treatment of depression by both providers and the HMO, including the dissemination of clinical practice guidelines to providers of depression care by the HMO.…”

Section: Discussionmentioning

confidence: 97%

Predicting Future Hospital Utilization for Mental Health Conditions

Kolbasovsky¹,

Reich²,

Futterman³

2006

J Behav Health Serv Res

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To develop a model using administrative variables to predict number of days in the hospital for a mental health condition in the year after discharge from a mental health hospitalization. Background, index hospitalization and preindex inpatient, emergency room, and outpatient utilization information were collected for 766 adult members discharged from a mental health hospitalization during a 1-year period. A regression model was developed to predict hospitalized days for a mental health condition in the year after discharge. A regression model was created containing five statistically significant predictors: Medicare insurance coverage, preindex mental health inpatient days, index length of stay, depression diagnosis, and number of mental health outpatient visits with a professional provider. It is possible to predict future mental health inpatient utilization at the time of discharge from a mental health hospitalization using administrative data, thus allowing disease managers to better identify members in greatest need of additional services and interventions.

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Section: Discussionmentioning

confidence: 97%

Predicting Future Hospital Utilization for Mental Health Conditions

Kolbasovsky¹,

Reich²,

Futterman³

2006

J Behav Health Serv Res

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“…Standard plans are required to ensure that at least 85 or 90 percent of the required specialists in their network, depending on region, are accepting new Medicaid patients [19]. And the travel time for enrollees in urban counties to see a psychiatrist must not exceed 30 minutes whereas, and the travel time for enrollees in rural counties to see a psychiatrist must not exceed 60 minutes [20].…”

Section: Discussionmentioning

confidence: 99%

The Performance of Florida Medicaid Health Plans on Follow-Up after Hospitalization for Mental Illness in 2014

Becker¹

2018

JOJPH

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According to Florida's Agency for Health Care Administration (AHCA), the agency that oversees the state's Medicaid program, the SMMC reform has been largely successful in providing high quality care to beneficiaries at lower costs to the state [4]. A January 2016 AHCA report, for example, shows that annual spending per beneficiary has trended downward since the SMMC reform was implemented and that beneficiaries tend to be highly satisfied with their health plans [5].Yet, while spending may be trending downward and overall satisfaction may be high, there is concern over the quality of health care being provided to the Florida Medicaid population

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“…Various strategies are known to improve performance on the HEDIS follow-up rates, and thus achieve good levels of follow-up care. Those strategies may include the development of a case management program for patients who are discharged 2 or focused discharge planning for those patients identified through predictive models as being at high risk for not keeping their outpatient appointments. 3 In 2004, Anthem Behavioral Health-Northeast (ABHNE) identified a quality improvement opportunity to increase HEDIS rates for posthospital follow-up care and chose an approach using nonclinical staff to facilitate first appointment attendance for discharged patients.…”

mentioning

confidence: 99%

Improvement of Psychiatric Ambulatory Follow-up Care by Use of Care Coordinators

Orlosky¹,

Caiati²,

Hadad³

et al. 2007

Am J Med Qual

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This study examined whether patients discharged from inpatient psychiatric care would improve rates of follow-up appointments when designated staff (ie, care coordinators) were assigned to coordinate care after hospital discharge. Data were collected from 1313 psychiatric discharges in 2003 and 1804 psychiatric discharges in 2004, principally from hospitals in the Northeast states. Patients' health care was managed by Anthem Behavioral Health-Northeast. Appointment verification was made through Health Plan Employer Data and Information Set methodology. Of the 1804 psychiatric discharges, 71.6% kept an outpatient appointment within 7 days of discharge, and 88.3% kept an outpatient appointment within 30 days of discharge. These rates were a statistically significant improvement ( P>.001) from the prior year's rates of 66.6% and 84.0%, respectively, when care coordinators were not used.

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Improving Continuity of Care: Success of a Behavioral Health Program

Cited by 6 publications

References 9 publications

Predicting Future Hospital Utilization for Mental Health Conditions

Predicting Future Hospital Utilization for Mental Health Conditions

The Performance of Florida Medicaid Health Plans on Follow-Up after Hospitalization for Mental Illness in 2014

Improvement of Psychiatric Ambulatory Follow-up Care by Use of Care Coordinators

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