Accessibility of Services

Community Care continually evaluates accessibility of behavioral health services. Assessing access entails the synthesis of various data measures, which includes objective measures related to telephone statistics as well as subjective measures related to a member’s perception of access. Performance measures related to service access have inherent member safety implications, and these measures enable Community Care to monitor that members obtain timely behavioral health appointments and have quick access to Community Care by telephone.

Community Care measures how quickly we answer the telephone (known as the average speed of answer) and the percentage of callers who hang up before their call is answered (known as the abandonment rate). Community Care’s goals related to these two measurements are 5% or less for the abandonment rate and 30 seconds or less for average speed of answer. From 2023 to 2025, Community Care continued to exceed these goals for average speed of answer and abandonment rates. 

Emergent and urgent access to services is measured through member calls to Community Care that require triage and referral. When a member calls seeking care, a Customer Service Representative routinely asks the member a series of questions to determine the urgency. If the responses indicate that the member needs to be seen right away, the call is transferred to a Care Manager who assesses the member’s level of acuity and works with a facility/practitioner to ensure the member has an appointment within the appropriate timeframe. Community Care has adopted related appointment access standards that meet or exceed state and national guidelines. Community Care members are entitled to:

  • Appointments offered for emergent needs within one hour
  • Appointments offered for urgent needs within 24 hours

From 2023 to 2025, Community Care members were able to obtain appointments within the standards for urgent and emergency needs 100% of the time in all contracts. Furthermore, complaints related to access time standards (emergent and urgent complaints) are used as a supplemental data source to evaluate appointment accessibility. Community Care received no complaints related to Emergent and Urgent calls in 2023, 2024, and 2025.

Access to routine behavioral health appointments is also measured by two questions on the annual Member Satisfaction Survey. The 2025 Member Satisfaction Survey access questions and results, which are based on experiences in 2024, were as follows:

  • “In the last 12 months, if you/your child needed a routine appointment for counseling or treatment, how often did you get an appointment for counseling or treatment as soon as you wanted (usually, always)?” 
    • The 2025 survey results reflect aggregate scores of 81.9% for children and 80.2% for adults. While the 82% goal was not obtained for either measure, each rate demonstrated improvement compared to the prior year.
  • “How long did you have to wait for an appointment (same day – seven days)?” 
    • The 2025 survey results show a child score of 74.2% and an adult rate of 75.4%, with the adult rate meeting the 75% goal.

Ongoing interventions designed to enhance members’ timely access to care and improve the related access measures include:

  • In 2021, Community Care developed an internal Network Accessibility Workgroup that has focused on becoming an innovator in access and a payor of choice. The group has also worked on capturing reliable data surrounding access, which includes the review of capacity, availability, and utilization. This workgroup includes senior administration, network, clinical, and quality staff so that the information can be synthesized to recommend contract-specific and company-wide interventions designed to increase access in areas of need. This workgroup is piloting projects related to network expansion, including innovation around the recruitment and retention of providers, conducting financial analysis of various incentive programs and rate increases, as well as exploring opportunities around the use of integrated, virtual and nontraditional care models. Specific workgroup interventions include the following:

    • Provider recruitment has been a key aspect of this work group, which developed a brochure about joining the provider network (CCBH-Recruitment-Brochure.pdf).

    • Community Care has implemented provider rate increases to encourage providers to join or remain within the network to help ensure members have ease of access to services.

    • In 2024, Community Care sent letters to in-network providers to acknowledge their value to the network, thank them for delivering needed services, and ask for feedback.

    • In 2023, the workgroup collaborated with the Primary Contractors to develop a monthly Child MH Service ePortal 30-day availability reporting process. Currently, information from the availability survey is now linked in real time to the member facing search function for providers who complete the availability survey (Appointment-Availability-–-Online-Provider-Directory.pdf).

    • Community Care provides Network Monitoring and Development Plans or NMDPs to primary contractors. These reports are designed to inform and support local decision-making and include key data points such as average monthly enrollment, penetration rates, and provider network composition, among others. Community Care uses these reports to help identify interventions and opportunity areas within specific services or levels of care.

  • Community Care has been collaborating with Primary Contractors on workforce stabilization initiatives. Community Care supports workforce development across the education and career continuum through targeted outreach and training initiatives. Efforts include engagement at the high school, undergraduate, and graduate levels, as well as certificate and internship opportunities to build entry pathways into the behavioral health workforce. Post‑training activities focus on professional development, job placement support, and ongoing partnerships with universities to strengthen workforce capacity.

  • Community Care’s Network Department implemented and expanded the Council for Affordable Quality Healthcare (CAQH) standard credentialing and re-credentialing application and continues the use of CAQH for re-credentialing, which is a universally accepted credentialing application accepted by most Managed Care Organizations. Providers are re-credentialed every three years with Community Care.  The ease of these processes should encourage providers to join or remain in the network, which would improve access.

  • Providers are required to notify Community Care if they are unable to see members within specified timeframes depending on acuity, as specified in the Community Care Provider Manual. Community Care also understands that providers at times cannot serve a member within expected access times, which are listed in Community Care’s Provider Manual, and may offer to place that member on a referral list so that members waiting to receive services are scheduled for appointments promptly as they become available. Community Care developed a “Referral List and Wait Time Management Best Practices” document that offers guidance to providers related to referral list management (Referral List and Wait Time Management Best Practices: HealthChoices Providers), and notified providers via a provider alert (Provider Alert 11: Referral List and Wait Time Management Best Practice).

  • Care Management ensures that members receive urgent, emergent, and/or routine services as part of their daily activities. For urgent levels of care, Care Managers will actively perform bed searches across the state for both inpatient and PRTF levels of care to ensure that members have rapid access to these categories of care.

  • Clinical Operations committees comprised of representatives from network, clinical, and program operations in each contract review all requests from prospective providers wishing to join the network. These committees consider geographic location and areas of provider specialization when expanding the network. Program descriptions are also reviewed to determine if any priority or special populations are served, or if unique services exist to meet the needs of the membership. The committees also review providers who have left the network to address any resulting gaps in coverage. From August 2024 to August 2025, a net total of over 1,265 new providers were added to the network.

  • Access expectations for emergent, urgent, and routine appointments are detailed for providers within the Provider Manual, which may be found on Community Care’s website (Community Care Provider Manual (ccbh.com).

  • Community Care maintains a webpage that outlines Access standards for members. This webpage also details Care Management interventions related to ensuring Access as well as how to contact Community Care if members are having problems getting an appointment soon enough to meet their needs (Getting an Appointment on Time: HealthChoices Members - Community Care (ccbh.com).

Community Care thanks network providers for ensuring HealthChoices members are offered timely access to services. Community Care looks forward to continued collaboration in meeting our members’ needs.