Outpatient follow-up care with a trained mental health provider is commonly regarded as a critical component of post-discharge planning for patients hospitalized for a mental health condition. Proper follow-up ensures patients continue to build off health gains made during hospitalization, patients are properly supported in their transition to home and/or work and providers detect early signs of possible preventable re-hospitalizations. Given the importance of proper post hospitalization follow-up care for mental health conditions, a measure of post-discharge follow-up care was included in the Healthcare Effectiveness Data and Information Set (HEDIS). HEDIS is a list of actionable metrics utilized by more than 90 percent of health plans in the United States, including the Military Health System (MHS), to measure performance on important dimensions of health care delivery. The Psychological Health Center of Excellence identified two potential issues with the original HEDIS metric detailed in the following report. To address these issues, PHCoE developed an alternative to the HEDIS metric. The following report provides a detailed description of PHCoE’s metric and includes fiscal year 2015 findings within the MHS utilizing this new methodology.
As with all administrative health care data, accuracy depends on provider coding practices. Consequently, provider coding that is inconsistent with established definitions used in metric calculation may result in failure of the metric to identify all instances of adequate follow-up accurately.
- The MHS achieved an 84 percent rate of 7-day follow-up among active duty service members hospitalized with a mental health condition in fiscal year 2015.
- Of the 16 percent of discharges for which patients did not receive proper follow-up care within 7 days:
- 34 percent had a missed opportunity for follow-up in a non-mental health outpatient setting.
- 42 percent had a missed opportunity for follow-up in a mental health care setting that did not meet the definition for an outpatient visit, intensive outpatient service or partial hospitalization.