A brief care management intervention offered to adults following their first psychiatric hospitalization can reduce readmission rates while increasing rates of outpatient aftercare, reports a study published today in Psychiatric Services.
“Although inpatient service is considered a poor outcome of behavioral health care, it provides an opportunity for care management intervention to address medication access, discharge and recovery planning, and connection to aftercare and other resources for continuity of care,” wrote Shari L. Hutchison, M.S., P.M.P., of Community Care in Pittsburgh, and colleagues
While Community Care—a nonprofit behavioral health managed care organization that is part of the University of Pittsburgh Medical Center Insurance Services Division—had already been offering a care management program to Medicaid-enrolled adults with multiple psychiatric admissions, the organization tested an expansion of the intervention to individuals with no prior inpatient history.
Hutchison and colleagues identified 5,140 Medicaid-enrolled adults across 71 facilities in Pennsylvania who had a first-time psychiatric admission in 2022 or 2023. Of this group, 48% received the 10- to 20-minute intervention from a trained care manager, while the remainder did not for various reasons (e.g., coordination issues, early discharge).
Overall, the 30-day psychiatric readmission rate was 9% among those who received the intervention and 11% among those who did not. After adjusting for differences in demographic characteristics and diagnoses between the groups, the researchers calculated that not receiving the intervention increased the odds of readmission by 28%. In addition, 26% of adults who received the care management intervention went to an outpatient appointment within 30 days of discharge, compared with 21% of those who did not.
The reduced readmission rate led to cost savings, with direct expenditures totaling $2.3 million for the intervention group, compared with $2.8 million for the comparison group. The researchers noted that further cost savings from providing this intervention early in an individual’s illness trajectory could be realized in the long term.
“[S]ervices are often prioritized for those with the highest need and costs, such as crisis or residential services targeted to individuals with multiple psychiatric admissions,” the researchers wrote. “Our findings support the necessity of having a diverse array of services within a behavioral health system of care.”
For related information, see the Psychiatric Services article “Care Management for Serious Mental Illness: A Systematic Review and Meta-Analysis.”
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