Mental Health Follow-Up Program Treatment Success Rate
Blue Cross and Blue Shield of Texas
Depression and related mental illnesses consistently ranked in the top five diagnoses by frequency and cost for HMO Blue Texas (HBT) members In response, HBT developed The Improving Follow-Up After Mental Health Admission program to ensure continuous care, minimize patient suffering and prevent repeat hospitalizations for mental health services.
Program Elements
- Identified the common barriers to follow up care after discharge from the hospital, including members' non-compliance with appointments, providers' weak follow-up care plans and timely scheduling of services, patient transportation issues and inconsistent communication between the inpatient facility and the company's outpatient care coordinators.
- Offered several member interventions to address barriers to post-discharge follow up, including:
- Appointment reminder phone calls and letters,
- Educational materials emphasizing the importance of aftercare compliance, and
- Intensive case management for highly non-compliant members.
- Delivered facility-level interventions to address barriers to care before they happened as well as post-discharge, including:
- Placement of Field Care Managers at selected high volume facilities,
- Standardization of discharge planning, including scheduling a timely follow-up appointment,
- Empowerment of care coordinators (through training) to intervene and modify a discharge plan if it does not include appropriate follow-up.
- Currently, interventions to address additional barriers to follow-up, including the widespread need for psychopharmacology follow up, are being integrated to further enrich the program.
Program Results
- By 2002, a decline in 7-day and 30-day follow-up seen in 2001 was reversed.
- By 2003, the number of members seen within 7 days of discharge improved by more than 20 percent over 2000 baseline measurements.
- Follow up by 30 days post discharge improved to 74 percent – on par with the national average and much improved over lagging 2000 baseline measurements.
Contact
Donna Ward, Director, Quality Improvement Programs, 972-996-8330, Donna_ward@bcbstx.com
