Provider-Payer Partnerships as an Engine for Continuous Quality Improvement.

Psychiatr Serv

Dr. Balfour, Dr. Fox, Ms. Morales, and Dr. Berdeja are with Connections Health Solutions, Tucson, Arizona. Dr. Balfour and Dr. Berdeja are also with the Department of Psychiatry, University of Arizona, Tucson. The remaining authors are with Cenpatico Integrated Care, Tucson. Marcela Horvitz-Lennon, M.D., and Kenneth Minkoff, M.D., are editors of this column.

Published: June 2018

The authors describe a quality improvement approach in which a crisis center and a payer collaborate to improve care. Each crisis visit is considered as a potentially missed opportunity for community stabilization. Daily data on crisis visits are sent to the payer for a more up-to-date analysis of trends than is possible with financial claims data, which may lag behind services provided by up to 90 days. Using these trend data, the two organizations collaborate to identify patterns that lead to opportunities for improvement and develop multiple rapid-cycle projects for better management of services, resulting in significant decreases in readmissions and in the number of high utilizers.

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http://dx.doi.org/10.1176/appi.ps.201700533DOI Listing

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