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Why do we have low slot utilization at Adelante for therapists? - Coggle…
Why do we have low slot utilization at Adelante for therapists?
Cancellations
They can't charge a no-show/cancel fee- no consequence
Too easy for pts to cancel- they can just text 24 hrs prior
Not enough time to fill the slot
Re-engagement- time-consuming
No way to undo a mistake cancellation if you hit the wrong button
Lack of visibility of cancelled appts in NextGen
Call center doesn't have ability to document cancellation in the chart
Therapists don't know what happened to that slot or who to re-engage/f/u with
Inconsistent practice of scrubbing schedule day prior?
Adelante re-engagement process ineffective
No-shows
Only way to track is via daily tracker
No consequence to pt for no-show
Lots of sliding scale pts- will pay for groceries over therapy
Scheduling processes
Errors in scheduling pts based on their insurance - often scheduled with therapists who aren't cred for that insurance
Adelante is supposed to do a 4-point check to ensure this happens; it is not happening consistently
Scheduling staff may not be looking at all options for Ascend when they schedule (usually looking at one or two providers)
Adelante scheduling intakes a week out when therapists are available much sooner (often same-day)
Referral Processes - Internal
Note: BHMP process is to send to Danielle (instead of prev to case mgr) ~ 32 for August)
BHMPs not referring very many patients
Not thinking about it
Template doesn't have question about therapy on it
Therapist may not be credentialed to take that insurance
May not see service as necessary/valuable
May not know the process to refer
May not have a rockstar therapist to refer to (may hinder their confidence in referring)
May not get feedback on benefit to their pts
Don't know if referral was successful.
There is a process and is working but providers are unaware
Culture/communication barrier where med management and therapy aren't working as a team
No staff meeting to connect BHMPs and therapists
May not have time within pt visit to mention therapy
Process to refer takes an extra minute or so; conversation takes much longer
May not have appropriate Dx to refer to therapy
No pt demand for therapy
Pt isn't asking for therapy because they think med mgmt is therapy
Not comfortable talking about clinical importance of adding therapy (e.g., could they speak to this like Josh Leslie could?)
Lack of directive to refer and value of doing so
Referral Processes- External
Adelante incentivized to fill own BH therapists (~30); may not be incentivized to fill ours. Note: In 2023, added lots of therapists this year, increased salaries, eliminated integrated team
Internal processes and changes
Reorg
We do not get referral data from Adelante
Staff turnover
Not using standard processes for referrals b/c of turnover and new people
Lack of relationships between our providers and Adelante providers
No opportunities to interface
Do they know our providers and how awesome they are?
We haven't presented data to make a strong case for WHY they should refer to us
PCPs not enthusiastic about BH services in general (cultural)
Intake Process
Adelante scheduling intakes a week out when therapists are available much sooner (often same-day) *doesn't need to be an intake specialist
Made change to intake- req counseling for all comm insurance pts to have intake prior to therapy or BHMP appt - leads to delay in care (prev. only for Access pts)