Clinical Quality Corner: Follow-up After Hospitalization for Mental Illness

The Follow‑up After Hospitalization for Mental Illness HEDIS^® measure** looks at the percentage of discharges for members age 6 or older who were hospitalized in an acute inpatient setting for treatment of mental illness or intentional self-harm and who had an outpatient visit, intensive outpatient encounter or partial hospitalization with a mental health practitioner within seven and 30 days after discharge.

Follow-up visits can also include a community mental health center visit, telehealth visit, observation visit, transitional care management services or electroconvulsive therapy.

Why is this measure important?

Following up in a timely manner may:

• Lower the chance of re‑hospitalization
• Detect adverse responses to medications early on
• Ensure progress made during hospitalization is retained
• Offer continued support

How can I ensure my patients are getting follow‑up visits?

If you are the discharging hospital or the mental health practitioner accepting the patient for outpatient follow‑up:

• Make sure the patient has a follow‑up visit scheduled within seven days before leaving your facility and that the outpatient provider has the capacity to see the patient within these seven days. Include this visit information in the discharge information that you send or share with Blue Cross Blue Shield of Michigan or Blue Care Network.
• Educate the member about the importance of keeping the appointment so they can avoid readmission and continue to make progress.
• Remember that patients are vulnerable after discharge from a psychiatric hospitalization. Continued care after stabilization in the hospital setting is important for them to maintain stability as they transition back into their environment.
• Cooperate with efforts by Blue Cross, BCN or New Directions Behavioral Health (a company that provides behavioral health services for most Blue Cross members)  to confirm that follow-up appointments were made and kept. Case managers sometimes provide additional reminders or follow-up calls to ensure member compliance with these appointments.

For more information
Check out the recently updated 2020 HEDIS Tip Sheet for this measure. It’s also posted on web-DENIS in the Clinical Quality Corner section of BCBSM Newsletters and Resources. See the article, “HEDIS measure tip sheets updated for 2020,” also in this issue, for more details.

**HEDIS, which stands for Healthcare Effectiveness Data and Information Set, is a registered trademark of the National Committee for Quality Assurance, or NCQA.