Provider Quality

PerformCare is committed to ensuring that providers in our network provide quality care. We do this in several ways:

  • Administrative compliance concerns. PerformCare associates identify when a provider submits a form that is late, incorrect, or incomplete. A PerformCare associate follows up with providers to help them learn ways to improve.
  • Consumer (Individual)/Family Satisfaction Team (C/FST) Surveys. PerformCare gathers feedback from adults, children, and families who have used mental health and/or substance use services paid for by PerformCare. These surveys focus on finding out how satisfied you are with your care, and ask questions related to many areas of treatment. C/FST Surveys are a part of provider profiling for those levels of care that have C/FST Survey results. PerformCare encourages you to participate if you are ever contacted for a C/FST Survey.
  • Quality of care concerns. PerformCare associates can make referrals to our Quality of Care Council when there is a concern that impacts member safety. PerformCare investigates these concerns and follows up directly with providers.
  • Treatment record reviews. PerformCare checks in on providers by meeting with them and reviewing some of the documents related to the care they provide.
  • Provider profiling. PerformCare collects information based on specific measures for certain levels of care (for example, the time it takes to get an outpatient appointment, or the average number of days in inpatient treatment) to examine how well providers perform in comparison to other network providers. Our goals are to give you information that may help you choose a provider and to help improve the quality of care for all members. If you have questions about provider profiling, please contact PerformCare and ask to speak with the Quality department.

    PerformCare profiles providers who have these services:

    • Community-based mental health services.
    • Family-based mental health services.
    • Mental health inpatient.
    • Mental health outpatient.
    • Mental health partial hospital.
    • Residential treatment facility.
    • Substance use inpatient services.
    • Substance use outpatient services.

View the member presentation on provider profiling (PDF) and then check out the results below.

Provider profiling results

Community-based mental health services

The community-based mental health services Provider Profiling Report (PDF) contains information for peer support services (PSS), psychiatric rehabilitation services (psych rehab), and case management services, including targeted case management, blended case management, intensive case management, and resource coordination.

For PSS, PerformCare reviews:

  • Amount of services received per member.
  • Length of time members remain in PSS.
  • Number of days until PSS starts.

For psych rehab, PerformCare reviews:

  • Amount of services received per member.
  • Length of time members remain in psych rehab.

For case management services, PerformCare reviews:

  • Amount of services received per member.
  • Length of time members remain in case management services.
  • Number of members who have more than one mental health hospitalization within 30 days.
  • How quickly the Case Manager sees a member after a mental health hospitalization.

Consumer/Family Satisfaction Team Survey results are available for CBMHS for 2023 (PDF). 

Family-based mental health services

Family-based mental health services Provider Profiling Report (PDF).

For family-based mental health services (FBMHS), PerformCare reviews:

  • Amount of services received per member.
  • Number of days until the service starts.
  • Number of members who have a mental health hospitalization while in service.
  • Type of treatment members received after discharge from FBMHS.

Consumer/Family Satisfaction Team Survey results are not available for family-based mental health services for 2023.

Mental health inpatient services

Mental health inpatient services Provider Profiling Report (PDF).

For the mental health inpatient level of care, PerformCare reviews:

  • How frequently members are going back into the hospital.
  • Follow-up appointments that members keep after a mental health inpatient stay.
  • Length of time the members are on the mental health inpatient unit.
  • Number of members who are being treated on a mental health unit who have both a mental health and a substance use diagnosis.

Consumer/Family Satisfaction Team Survey results are available for mental health inpatient services for 2023 (PDF).

Mental health outpatient services

Mental health outpatient Provider Profiling Report (PDF).

For mental health outpatient services, PerformCare reviews:

  • Number of members who were offered an appointment within seven days.
  • Number of members who continue to attend therapy.

Consumer/Family Satisfaction Team Survey results are available for mental health outpatient services for 2023 (PDF).

Mental health partial hospitalization

Mental health partial hospitalization Provider Profiling Report (PDF).

For partial hospitalization (PHP), PerformCare reviews:

  • Number of members who keep appointments after PHP.
  • Number of members who were offered services within seven days.
  • Number of members in PHP who have both mental health and substance use diagnoses.
  • Number of members with a substance use diagnosis who go to treatment after PHP.
  • Number of members who have a mental health hospitalization after discharge from PHP.

Consumer/Family Satisfaction Team Survey results are available for mental health partial hospitalization for 2023 (PDF).

Residential treatment facility

Residential treatment facility Provider Profiling Report (PDF).

For residential treatment facility (RTF), PerformCare reviews:

  • Type of treatment members received after discharge from RTF.
  • Most frequent age groups and diagnoses in RTF.
  • How long members remain in RTF.
  • Number of members who had a mental health hospitalization during RTF or after discharge from RTF.
  • Provider practices to support family involvement in treatment.

Consumer/Family Satisfaction Team Survey results are not available for residential treatment facility for 2023.

Substance use inpatient services

Substance use inpatient services Provider Profiling Report (PDF).

This report covers detoxification programs, rehabilitation programs, and halfway houses. For substance use services, PerformCare reviews:

  • Number of members who return to treatment within 60 days.
  • Type of substance use disorder being treated.
  • Number of members who have both mental health and substance use diagnoses.
  • Follow-up appointments that members keep after treatment.
  • How long members remain in services.

Consumer/Family Satisfaction Team Survey results are available for substance use inpatient services for 2023 (PDF).

Substance use outpatient services

Substance use outpatient services Provider Profiling Report (PDF).

This report covers substance use outpatient (OP), intensive outpatient (IOP), and partial hospitalization programs (PHP). For substance use outpatient services, PerformCare reviews:

  • Number of members who are offered OP, IOP, and PHP services within seven days.
  • Number of members who continue to attend outpatient therapy.

Consumer/Family Satisfaction Team Survey results are available for substance use outpatient services for 2023 (PDF).

Consumer/Family Satisfaction Team Survey results are available for
Members