Improving continuity of care: success of a behavioral health program.
This article documents the quality improvement process implemented by HIP Health Plan of New York (HIP) for the behavioral health continuity-of-care measure, Follow-Up After Hospitalization for Mental Illness. This Health Plan Employer Data and Information Set (HEDIS) measure identifies the percentage of members who receive psychiatric follow-up care after their hospital discharge. Studies indicate that post-hospitalization psychiatric follow-up care is an effective method for reducing hospital readmissions. HIP's mental health services department pursued a number of improvement initiatives with this HEDIS measure. The development of a case management unit proved the most effective intervention as compliance rates for post-hospitalization after-care visits improved and hospital readmittance rates declined. These findings provide valuable resource information for behavioral health providers throughout the United States.
Reich
Leonard H
LH
Mental Health Services, HIP Health Plan of New York, New York, NY, USA. lreich@hipusa.com
Jaramillo
Beatriz M
BM
Kaplan
Lisa J
LJ
Arciniega
Jacqueline
J
Kolbasovsky
Andrew D
AD
D000068:Accreditation; D000359:Aftercare; D001524:Behavioral Medicine / Q000592:standards*; D019090:Case Management; D003266:Continuity of Patient Care / Q000592:standards*; D019983:Guideline Adherence; D006264:Health Benefit Plans, Employee / Q000592:standards; D006297:Health Services Accessibility; D006760:Hospitalization; D006801:Humans; D008329:Managed Care Programs / Q000592:standards*; D001523:Mental Disorders / Q000628:therapy; D008605:Mental Health Services / Q000592:standards*; D009518:New York; D015397:Program Evaluation; D017749:Total Quality Management / Q000458:organization & administration*