Blue Cross designates partial hospitalization programs for patients with eating disorders

To help members identify psychiatric treatment programs that focus on eating disorders, Blue Cross Blue Shield of Michigan will designate eating disorders programs offering partial hospitalization programs that meet the requirements detailed below.

Eating disorders partial hospitalization programs provide comprehensive and intensive treatment while allowing patients to live at home and maintain some social activities and contacts. Partial hospitalization is ideal for patients with eating disorders who require treatment at a more intensive level than that provided in the outpatient setting.

Designated providers will be identified in our  Find a Doctor feature on bcbsm.com. The designation of eating disorders partial hospitalization programs will:

• Recognize and promote high quality programs
• Improve awareness and access to eating disorders partial hospitalization programs in Michigan
• Facilitate options for successful transitions from inpatient treatment to outpatient treatment
• Reduce the need for medical or psychiatric hospitalization by providing more intensive treatment than outpatient treatment
• Reduce the need for stays at residential treatment facilities
• Not impact current contract arrangements with partial hospitalization providers

Key designation requirements
Partial hospitalization programs must be licensed as a partial hospitalization program by the State of Michigan. A multidisciplinary staff is required, including a physician director, a psychiatrist (who may also be the physician director) or fully licensed psychologist, a master’s level social worker, a licensed registered nurse and a licensed dietician.

Partial hospitalization program components

• Six hours per day, at least five days per week
• Program components must include, at a minimum:
• Three physician visits per week, either medical or psychiatric (with at least one medical visit per week)
• Two therapy sessions per week, one of which must be with family or adult support
• Didactic presentations lasting 1- 1.5 hours per session, limited to 15 patients in a group, one per day
• Group psychotherapy lasting at least 1.5 hours per session, with a maximum of 12 members, one per day
• Two supervised meals per day
• Nutritional services provided by a dietician
• One of the following adjunctive services per day:
• Behavioral modification, occupational therapy, recreational therapy, goal oriented social groups, creative expressive therapy and community meetings
• Programs should use validated and well-recognized measures to track patients’ progress and should be able to provide information on program outcomes on an aggregate basis, including measures discussed above, readmission rates and follow-up data.

You can find more details about BCBSM designated eating disorder programs, including program criteria and application materials by visiting web-DENIS:

• Click on BCBSM Provider Publications and Resources.
• Click on Newsletters and Resources.
• Click on Clinical Criteria and Resources.
• Click on Eating Disorders Program Resources.

Materials can also be obtained by sending an email to  ValuePartnerships@bcbsm.com.