If behavioral health centers want to be a part of the burgeoning integrated care environment, they have to offer clients same day access.
Same day access is not optional any more, said Scott Lloyd during a National Council for Behavioral Health webinar on the topic. Lloyd is the president of MTM Services, a consulting arm of NCBH.
“Consumers are voting with their feet,” he said. “They’re showing us that ‘we want to be able to get in more quickly,’ and if we’re not offering that to them and we’re not giving that to them, they’re looking for other places … and there’s more places for them to go now, so we’re losing some of those clients that in the past would have just waited – or not received the help they need, which is even worse.”
Behavioral health centers may worry about switching from traditional assessment/intake appointments to same day access, but it’s not as intimidating as it seems, Lloyd said, if the model is handled properly.
There are five key steps to making the switch, he said.
Determine if the demand for services at your center justifies making the move to same day access. To justify same day access five days a week, your center will need a minimum of 50 successful intakes per month. If you don’t meet that minimum, you can arrange a hybrid model that would, for instance, allow for three days of same day access each week. Plan staffing. Many behavioral health centers worry that they’ll have to add staff in order to accommodate same day access, but most find they actually need fewer full-time equivalents, said Lloyd. Each center needs to decide if they’ll use a set team of providers or a rotating team. The advantage of a set team is that they do it everyday so they become efficient at the process. If the clinicians on the hand-off team can’t capture all the information accumulated by the set team, which means the client would have to repeat himself or herself, you may want to use a rotating team instead, Lloyd said. The challenge with using a rotating team is that more management to make sure there’s enough coverage and that the system is working properly is required. It’s also important to have contingency staffing – clinicians who can fill in if/when needed. Telemedicine options can be a good solution, too. Plan the transition and scheduling post-transition. Kick off same day access while still taking traditional assessment/intake appointments and gradually move to just same day appointments for assessment/intake. If stop taking traditional appointments and tell clients same day access will be available starting March 1, for instance, Lloyd said, you’ll end up with a deluge of same day appointments on March 1. You will need additional staffing during the transition – some to cover traditional appointments and some for same day appointments. To accommodate families who prefer appointments in the 3 p.m. to 6 p.m. period, you can set your schedule for walk-in appointments from 9 a.m. to 2 p.m., for example, and offer families the option of scheduling 24 hours ahead for the 3 p.m. to 6 p.m. time period. Same day access appointments are for assessment/intake; you’ll continue to use advance scheduling for follow-up/recurring appointments. The purpose of same day access is to eliminate/reduce assessment/intake appointment no shows and to get clients seen sooner. Make good use of wait time by choreographing pre-session activity. Break up the paperwork to keep same day access clients busy as they wait for their appointment. This also reassures them that they haven’t been forgotten. Create procedures for prior approval situations. Monitor your progress once you are transitioned to the same day access model. Use data to evaluate how you’re doing and to make tweaks to your process. Remember to open up your case loads so you will have a place to put clients.Using the same day access model isn’t just about eliminating no shows and cancellations, Lloyd said. This model will impact the entire business. For example, behavioral health centers (in a study of 169 organizations in 25 states) that changed to same day access saved an average of 1.2 hours in staff time, reduced their client wait times (number of days) by 44 percent, increased their intake volume by 10 percent and saved annually $20.1 million.