1. Onsite Quarterly Meeting PMHP Collaborative PIP Follow-up Within Seven Days After Acute Care Discharge for a Mental Health Diagnosis January 11, 2012 Presenter: Christy Hormann, LMSW, CPHQ Project Leader-PIP Team

2. Overview  History of PMHP Collaborative PIP  Remeasurement 3 results  Next Steps 2

3. History of PMHP Collaborative PIP  The PIP was initiated in 2007  Started with three study indicators 3

4. History of PMHP Collaborative PIP cont.  Starting in FY 10-11, the two case-manager related study indicators were discontinued  The remaining study indicator measured outpatient follow-up with a mental health practitioner within seven days of discharge  In FY 10-11, the second remeasurement was reported  Based on the results, it was determined that the PIP would continue 4

5. Results  Remeasurement 3 results were reported for FY 11-12  HSAG will assess for improvement between Remeasurement 2 and Remeasurement 3  HSAG will also assess for overall sustained improvement from baseline to Remeasurement 3 5

6. Interventions  The PMHPs implemented plan-specific interventions  There was discussion of a possible collaborative intervention in 2008 and the issue was revisited in 2010  In April 2011, a collaborative intervention was agreed upon by the PMHP group  The collaborative intervention is follow-up telephone contact with members after an inpatient discharge 6

7. PMHP Results for Study Indicator 1—Percentage of members who have an outpatient follow-up encounter with a mental health practitioner within seven days of discharge. Plan Name Baseline CY 2007 Remeasurement 1 CY 2008 Remeasurement 2 CY 2009 Remeasurement 3 CY 2010 Rate A13.5%47.1%34.5%43.4% B15.8%34.4%36.7%36.0% C13.8%39.7%41.0%40.1% D13.8%44.6%37.2%33.1% E13.5%47.1%34.5%43.4% F25.1%33.4%44.1%40.6% G20.8%28.5%29.6%27.2% H28.8%31.3%39.3%33.5% I20.2%34.7%25.8%25.6% J21.7%22.3%29.2%24.5% K16.4%26.2%29.2%35.7% L49.3%67.8%71.2%39.8% 7

8. Study Indicator 1—Percentage of members who have an outpatient follow-up encounter with a mental health practitioner within seven days of discharge.  All except one of the PMHP PIPs reported third remeasurement rates that demonstrated improvement from baseline  Eleven of the PMHP PIPs achieved statistically significant improvement from baseline to the third remeasurement 8

9. Key Improvement Concepts  Know the rates for applicable demographic subgroups  Prioritize barriers; all barriers do not have to be addressed 9

10. Key Improvement Concepts cont.  Strategize interventions and intervention types based on barrier analysis  Identify an evaluation plan for each intervention 10

11. What’s Next?  PMHPs were asked to complete subgroup analysis  Interventions might need to be modified based on the results 11

12. What’s Next?  PMHPs should evaluate the effectiveness of their plan-specific interventions  Strategies-surveys, interim measurements  Successful interventions should become a standard part of the process 12