Magellan Healthcare
Provider Focus Newsletter
News & information for Magellan network providers

region/plan-specific news : Commercial Health Plans in AZ, DC, DE, FL, GA, IL, MD, NJ, OH, PA, TX, VA

For patients who have been hospitalized, follow-up appointments are vital

Whether you are with an outpatient practice or are on staff at a facility, it is vital that you encourage patients in your care to make and keep their follow-up appointments after discharge from hospitalization for mental illness. Follow-up care is critical for their health and wellbeing.

Medical literature1 shows that aftercare reduces the rate of avoidable readmissions, and close follow-up reduces incidents of suicidal ideation, suicide attempts and completed suicide.

How you can help

  • Schedule 7-day and 30-day follow-up appointments with members following hospitalization for mental illness. The appointment must be with a mental health provider: psychiatrist, psychologist, clinical social worker or other therapist.
  • Utilize telehealth instead of in-person appointments if you think this will help the member keep the appointment (when appropriate).
  • Educate patients in your care about the importance of keeping their follow-up appointments, especially patient groups (e.g., Medicaid and Medicare) who characteristically have low rates of follow-up.

What the numbers show

Health plans that Magellan serves in the states listed above have stated that follow-up after hospitalization (FUH) appointments are a priority. It’s also an industry standard for the National Committee for Quality Assurance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) surveys assess providers’ compliance with the measure for follow-up after hospitalization for mental illness.2

We’ve seen the rates of FUH decline over the past three years. This may be due, at least in part, to Magellan managing plans with more Medicare and Medicaid members, who are less likely to attend aftercare appointments.

HEDIS® Follow-up After Hospitalization for Mental Illness (FUH) Measure Results

Measure

HEDIS® 2018

HEDIS® 2019

HEDIS® 2020

Total Members

Members Engaged

%

Total Members

Members Engaged

%

Total Members

Members Engaged

%

7-day FUH

12,436

4,825

38.8%

12,446

3,901

31.3%

9,872

3,042

30.81%

30-day FUH

11,912

7,066

59.3%

11,063

5,696

51.5%

8,412

4,209

50.04%

HEDIS rates for follow-up after hospitalization measure show decline over three years.


Resources you can use

Check out the follow-up after hospitalization resources available through MagellanProvider.com.

 

Thank you for your continued commitment to improved behavioral health for our members!


 

1Beadles, C.A., et al. First Outpatient Follow-Up After Psychiatric Hospitalization: Does One Size Fit All? Psychiatric Services, April 2015; Vol. 66, No. 4.

2Follow-Up after Hospitalization for Mental Illness is one of the HEDIS behavioral health measures. Designed by the National Committee for Quality Assurance (NCQA), the Healthcare Effectiveness Data and Information Set (HEDIS®) is a collection of over 90 measures consisting of various evidence-based clinical guidelines for services rendered to commercial, Medicare and Medicaid HMO, POS and PPO plan members. More than 90 percent of America's health plans use this tool to measure performance on critical dimensions of care and service. 

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About Provider Focus

Welcome to Provider Focus, our award-winning e-newsletter for network providers! Here you’ll find articles and information to keep you up-to-date on news and topics relevant to serving Magellan members, including a section for regional- and plan-specific news. Check back as a new issue is released each quarter.

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