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Care Coordination

Care coordination between two or more providers is essential for good member care and continuous treatment. High-quality referrals ensure members transition smoothly from one level of care to another. Accountability and relationship-building are vital for good care coordination among mental health hospitals, targeted case managers, residential treatment facilities, and other community mental health outpatient providers.

PerformCare surveys providers annually for their input on care coordination. We look for opportunities to improve so members can benefit from safe, effective, and timely member-centered coordination.

2018 Care coordination survey results

The total number of participants was 110, which was slightly less than previous years. There were very few changes to the surveys, which included language clarification and removal of one question. These changes were made to increase validity and reliability of the survey.

2018 take-a-ways:

  • There was moderate improvement in sufficient, accurate, and timely clinical information received at the time of admission in substance use inpatient, residential treatment facilities and targeted case management; however, there was no measurable improvement noted in mental health inpatient, family-based, and behavioral health rehabilitation services.
  • In general, there was moderate improvement in providers coordinating with other providers concerning treatment team meetings; however, there was no change in coordinating with other providers concerning an after-care plan.
  • In general, there was a moderate increase in providers outreaching to PerformCare to address members’ barriers to treatment.
  • In general, there was a positive improvement in discharge plans, including a date and time of the first appointment; however, natural supports in after-care planning decreased slightly.
  • Sixty percent of the time providers reported that other providers returned their outreach calls within two business calls. On a positive note, 86 percent of discharge summaries are sent out to the next level of care within 14 days. This is better than the industry standard of 30 days.
  • Fifteen providers indicated they now have a staff member outreaching discharged members to ensure they continue with their follow-up care and to address barriers to treatment. This is a moderate increase from the previous year.

An area of needed improvement continues to be good coordination from provider to provider. As noted above, 60 percent of the provider-to-provider calls are returned within two business days, but 40 percent of the time it takes a week or longer before calls are returned.

Valuable time and missed opportunities to communicate and coordinate are lost before the member’s discharge. PerformCare will continue to outreach to a few levels of care throughout the year to discuss barriers to completing good coordination and find solutions to improve care for our members.

This table (PDF) indicates the percentage of providers who scored the question as either 100 percent – 91 percent of the time or 90 percent – 81 percent of the time. The goal was a score of 81 percent or better.

2017 Care coordination survey results

2016 Care coordination survey results