Follow-up Care for Mental Health

March 2024

Follow-up Care for Mental Health

Among Americans ages 18 to 44, nearly 600,000 are hospitalized yearly for mental health-related conditions, according to the National Alliance on Mental Illness. A recent study found that mental health-related visits to emergency departments have increased among children and young adults. Timely follow-up care after these visits is linked to improved health outcomes and fewer repeat hospital visits, according to the National Committee for Quality Insurance. You can help our members by encouraging follow-up care with behavioral health care providers when appropriate.

We track data for the following Healthcare Effectiveness Data and Information Set (HEDIS^®) measures to help assess our members’ care:

Follow-up after Hospitalization for Mental Illness
FUH applies to members ages 6 and older who had a follow-up visit with a mental health provider after they were hospitalized for the treatment of mental illness or intentional self-harm. FUH captures the percentage of discharges for which members had a follow-up visit:

Within 30 days of discharge (31 total days)
Within seven days of discharge (eight total days)

Follow-up after Emergency Department Visit for Mental Illness
FUM captures the percentage of ED visits for which members ages 6 and older with a diagnosis of mental illness or intentional self-harm had a follow-up visit:

Within 30 days of the ED visit (31 total days)
Within seven days of the ED visit (eight total days)

Tips to Close Gaps in Care

For EDs and hospitals:

Help our members schedule an in-person or telehealth follow-up visit with a mental health provider within seven days of discharge. The follow-up visit must be on a different date than the discharge date.
Consider member preference for treatment, allowing members to take ownership of the treatment process.

For providers:

Encourage members to bring their hospital discharge paperwork to their first appointment.
Educate members about following up and adhering to treatment recommendations.
Use the same diagnosis for mental illness at each follow-up visit. A non-mental illness diagnosis code won’t fulfill this measure.
Coordinate care between behavioral health and primary care providers:
Share progress notes and updates
Include the diagnosis for mental illness
Reach out to members who cancel appointments and help them reschedule as soon as possible

HEDIS is a registered trademark of NCQA.

The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.

BLUE REVIEW^SM

for Providers