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Brief Report

Published Date: 13 February 2025

Elimination of Behavioral Health Wait Times: Impact on “Avoidable” Medical Visits, Productivity, and Revenues

Jules Rosen, M.D. https://orcid.org/0009-0003-1672-0707 drjulesrosen@gmail.com, Michelle Hoy, L.P.C., C.A.S., Lucy Cordts, L.C.S.W., B.A.C.S., Andrea Laplante, Psy.D., Dustin Baker, M.P.H., and Daniel Maeng, Ph.D.Authors Info & Affiliations

Publication: Psychiatric Services

https://doi.org/10.1176/appi.ps.20240287

Abstract

Objective:

Delayed access to behavioral health services results in poor outcomes and higher costs. This brief report describes the elimination of a 702-person behavioral health waitlist through phase-based care (PBC), an innovative approach that aligns behavioral health resources with new patients with high-acuity need.

Methods:

Two PBC clinics, one triage and another high-acuity treatment, were established. Comparisons of pre-post interventions analyzed nonbehavioral health medical encounters, behavioral health productivity, and no-show rates.

Results:

Of 702 waitlisted persons, 614 attended triage clinics within 3.5 months, with patients needing acute care (37%) entering the treatment clinic within 2 weeks. Following evaluation, the waitlisted patients had 23% fewer medical encounters per month (p<0.001), behavioral health revenues increased 29% (p<0.001), behavioral health visits increased 165% (p<0.001), health evaluations increased 287% (p<0.001), and no-shows decreased 33% (p<0.001).

Conclusions:

Reallocating resources to new patients and those needing acute care resulted in increased behavioral health evaluations and productivity and reduced nonbehavioral health services without adding staff.

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Information & Authors

Information

Published In

Go to Psychiatric Services

Go to Psychiatric Services

Psychiatric Services

History

Received: 26 June 2024

Revision received: 4 September 2024

Accepted: 4 November 2024

Published online: 13 February 2025

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Authors

Details

Jules Rosen, M.D. https://orcid.org/0009-0003-1672-0707 drjulesrosen@gmail.com

Care Connect LLC, Whitewater, Colorado (Rosen, Hoy); CrescentCare, New Orleans (Cordts, Laplante, Baker); University of Rochester Medical Center, Rochester, New York (Maeng).

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Michelle Hoy, L.P.C., C.A.S.

Care Connect LLC, Whitewater, Colorado (Rosen, Hoy); CrescentCare, New Orleans (Cordts, Laplante, Baker); University of Rochester Medical Center, Rochester, New York (Maeng).

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Lucy Cordts, L.C.S.W., B.A.C.S.

Care Connect LLC, Whitewater, Colorado (Rosen, Hoy); CrescentCare, New Orleans (Cordts, Laplante, Baker); University of Rochester Medical Center, Rochester, New York (Maeng).

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Andrea Laplante, Psy.D.

Care Connect LLC, Whitewater, Colorado (Rosen, Hoy); CrescentCare, New Orleans (Cordts, Laplante, Baker); University of Rochester Medical Center, Rochester, New York (Maeng).

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Dustin Baker, M.P.H.

Care Connect LLC, Whitewater, Colorado (Rosen, Hoy); CrescentCare, New Orleans (Cordts, Laplante, Baker); University of Rochester Medical Center, Rochester, New York (Maeng).

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Daniel Maeng, Ph.D.

Care Connect LLC, Whitewater, Colorado (Rosen, Hoy); CrescentCare, New Orleans (Cordts, Laplante, Baker); University of Rochester Medical Center, Rochester, New York (Maeng).

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Notes

Send correspondence to Dr. Rosen (drjulesrosen@gmail.com).

Competing Interests

Dr. Rosen and Ms. Hoy, cofounders of Care Connect LLC, consult with community behavioral health programs, including CrescentCare, a federally qualified health center, to enhance efficiency and outcomes and to increase access to behavioral health services. Dr. Rosen is also the chief executive officer and Ms. Hoy a subcontractor of Summit Behavioral Health. Dr. Maeng served as a statistician for this study and received payment for the service.

Funding Information

The study was funded by grants from Gilead’s Zeroing In: Ending the HIV Epidemic and from the Substance Abuse and Mental Health Services Administration.

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Innovation in behavioral health delivery to enhance clinical and financial outcomes.

What is it about?

Public behavioral health programs have long waitlists resulting in increase no-show rates and high rates of "avoidable" medical and emergency services. Phase-based Care uses 4 principles to eliminate wait times and gain rapid recovery. In this paper, we describe an FQHC behavioral health clinic with a 702 person-wait list that was eliminated in 3.5 months. Comparing 6-months pre- and post intervention, behavioral health revenues and productivity increased, and avoidable medical visits and no-show rates decreased.

Why is it important?

Our behavioral health system is overwhelmed by increasing demands. The rote explanation for delays is understaffing. We have demonstrated in this and a previous publication, that through organizational and cultural change of Phase-based Care, rapid engagement and recovery can be attained without additional staff.

The following have contributed to this page:

Jules Rosen

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