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Follow-Up Care Guidelines for Mental Health-Related Inpatient Admissions

Tuesday, October 24, 2023

Outpatient follow-up care is vital after a psychiatric hospital discharge. Evidence shows that timely aftercare can lead to improved treatment outcomes and fewer readmissions. Non-active duty service member (ADSM) TRICARE Prime beneficiaries are not receiving this critical care often enough. Health Net Federal Services, LLC (HNFS) would like to partner with you to improve this.

What exactly are we measuring?

We are measuring the National Committee for Quality Assurance (NCQA®) Healthcare Effectiveness Data and Information Set (HEDIS®) “Follow-up After Hospitalization for Mental Illness” rates. We are tracking the number of non-ADSM TRICARE Prime beneficiaries in the TRICARE West Region who were:

  • Aged six years and older,
  • Hospitalized for select mental health disorders or intentional self-harm diagnoses, and
  • Had an aftercare appointment (outpatient visit, intensive outpatient or partial hospital encounter) with a mental health practitioner within 7 and 30 days after discharge.

What is HNFS' goal?

HNFS aims to improve our rates and reach the NCQA Quality Compass national averages for “Follow-up After Hospitalization for Mental Illness.”

How can you help?

Before you discharge a non-ADSM TRICARE Prime beneficiary from an inpatient mental health admission, confirm you have done the following:

  • Arranged for the patient to have a follow-up appointment with a mental health care provider such as a psychologist, social worker, counselor, psychiatric mental health clinical nurse specialist, or psychiatrist.
  • Given the patient a discharge card or an easy-to-understand form that includes the follow-up mental health care provider’s information and the appointment details.
  • Actively included family/caregiver(s)/significant others in the patient’s discharge process.
  • Checked to make sure the patient and family/caregiver understand the aftercare plan.

Additional steps you can take:

  • Implement a policy that mental health follow-up appointments must be within seven days.
  • Inform staff of the mental health follow-up quality measure.
  • Make mental health follow-up guidelines part of your facility’s annual quality improvement work plan.

If you need help locating mental health care providers in the TRICARE West Region, use our Network Provider Directory or contact our customer service line for 24/7 provider locator services.