OBJECTIVES: Waiving cost share for the first Mental Health and Substance Use Disorder (MHSU) follow-up visit after MHSU hospitalization is a Blue Cross and Blue Shield of Louisiana health care quality improvement program designed to remove potential financial barriers that the follow-up visit must take place within seven days of discharge from an inpatient stay. A mental health provider must perform the follow-up visit. The purpose of this effort is to encourage patient compliance of completing follow-up visits within seven days of a MHSU inpatient discharge. Follow-up within seven days helps close the gap for the Follow-Up After Hospitalization for Mental Illness (FUH) HEDIS measure. This study evaluates the clinical and financial effect of this waived cost share.

METHODS: The study investigated differences in health care utilization and expenditures for members who received this waived cost-share benefit post-discharge verses members who did not receive this benefit. Health care claims data identified MHSU hospitalization and follow-up visits within seven days. The study window is January 2020 to January 2021. The two cohorts were matched on demographics, mental health metrics, member risk score and comorbidities. Difference-in-difference analysis using a regression model with gamma and Poisson distribution were conducted for utilization and cost respectively.

RESULTS: The results indicate that members who received the benefit had an increase in follow-up visits. This includes a reduction of 23.1% in MHSU hospitalization, a reduction of 16.4% in all-cause emergency room visits, and a savings of 13.7% in medical cost among the members who received the benefit of waived cost share.

CONCLUSIONS: These findings recommend that waiving cost share for the first MHSU follow-up visit encouraged patients to complete that visit within seven days after the MHSU inpatient discharge and resulted in a reduction of health care utilization and expenditure.