Quality Care is Our Top Goal

We are committed to improving the health of all Community Care members. Our mission is to provide the highest quality mental health and substance use programs and services at the lowest possible cost, delivered in an environment that promotes recovery.

We help a diverse group of people. We do all that we can to meet our members’ special needs and preferences. We also make sure our staff and providers are sensitive to your needs. We are able to meet our members’ special requests related to cultural, racial, ethnic, disability and linguistic needs, and other special requests, as we have a varied provider network.

Community Care has Quality Improvement (QI) Program that is overseen by a Quality Improvement (QI) Committee. The QI Committee includes representatives from the community and Community Care leadership. The QI Committee identifies issues that are important to you. We set goals for these areas and check them annually to be sure we meet our goals. The QI Committee studies the results of our measurement activities and takes action to improve performance when we do not achieve our goals. This entire process is ongoing. We continually measure our performance, study results, and work to improve our processes and services. 

The overall goals of Community Care’s QI Program are to: 

  • Provide the highest possible quality care that recognizes differences and your unique needs and preferences.
  • Honor choices.
  • Provide timely care and service. 
  • Make your overall experience highly satisfying.
  • Ensure your safety to the highest degree possible. 
  • Promote continuity and coordination of care. 
  • Provide outstanding customer service. 

We receive input from the provider community through the Provider Advisory Committee (PAC). Network practitioners on the PAC keep Community Care informed about what is happening in the network and provide recommendations to the QI Program about activities such as clinical practice guidelines. The PAC also review results from measurement activities and member provider satisfaction surveys to provide input from the practitioner’s perspective. The PAC is involved when new QI activities or initiatives are planned to ensure their perspective is adequately reflected in the process. The also foster buy-in for new projects. Community Care places high value on maintaining a collegial relationship with our provider network. 

Some of the things we monitor are: 

  • The composition of our network to be sure we have the right number of providers and facilities within an appropriate driving distance of members.
  • The timeliness of appointments to be sure members with urgent care needs can see a provider within 24 hours, and members with routine care needs can see a provider within 7 calendar days. 
  • The time it takes customer service to answer the telephone to be sure your calls are answered within 30 seconds or less. 
  • Member complaints to be sure complaints are fully investigated and actions are taken as appropriate within the required time frames for routine and clinically urgent complaints.
  • Member appeals to be sure adequate consideration is given to issues of disagreement and actions are taken as appropriate within the required time frames for routine and clinically urgent appeals.
  • Overall member satisfaction with services provided by Community Care and its providers so we can identify areas of dissatisfaction and take actions to improve in these areas. 
  • Adherence to clinical practice guidelines so we can improve clinical safety. Community Care continually seeks to implement new and innovative interventions to improve the rate of follow-up after inpatient discharge.

Community Care conducts an annual member satisfaction survey. One thing this survey measures is satisfaction with Community Care customer service staff. In 2024, our customer service member satisfaction rates were 72.47% for the adult survey and 66.5% for the child survey. The adult rate did not meet the 78% goal, nor did the child rate meet the 72% goal. The adult score slightly increased when compared to the 2023 rates. The child score decreased when compared to the 2023 rate. To continue to improve on these rates, several interventions were implemented and continue. Customer service staff end each call by asking, “Are you satisfied with you call today.” If a member answers in the negative, the call is immediately routed to a customer service representative to address the issue. Customer service staff continue to receive trainings on different aspects of our available services to improve member satisfaction. In addition, an automated member satisfaction survey at the end of each call continues. Members report satisfaction with their calls over 97% of the time. 

Community Care is also working to improve the rate of follow-up appointments after an inpatient mental health hospitalization. This is measured at both 7 days and 30 days post discharge. For 2023, we broke the data down further by race. The 7-day follow-up rates post discharge were: 

  • White members – 41.7%
  • Black members – 32.7%
  • American Indian/Alaskan Native members – 44.0%
  • Asian members – 43.1%
  • Other or chose not to respond – 38.4%

The 30-day follow-up percentages post discharge were:

  • White members – 62.0%
  • Black members – 50.6%
  • American Indian/Alaskan Native members –67.9%
  • Asian members – 61.9%
  • Other or chose not to respond – 57.3%

In reviewing broader racial trends, it is notable that follow-up rates for most of the races demonstrated consistent decreases from 2021 to 2023. For example, White members’ 7-day follow-up rates decreased from 43.8% in 2021, 41.8% in 2022, to 41.7% in 2023, while the 30-day follow-up rates decreased from 65.1% in 2021, 64.0% in 2022, to 62.0% in 2023. Aggregately, two races’ (American Indian/Alaskan Native and Asian) 7- and 30- day follow-up rates increased from 2022 to 2023, however, the lower Ns and Ds for these two populations make these rates more vulnerable to fluctuations.

Community Care regularly aggregates data related to the effectiveness of care management projects targeted to increase follow-up. The data demonstrates that members who receive targeted interventions, including support from a CHW, Pre/Post-Natal Care Management, an ICP, HRCM, Admission Interview, and Aftercare Outreach had higher follow-up rates at both 7- and 30-days. Data shows that interventions of ICP and Admission Interviews are also effective specifically for Black/African American members. These findings strongly indicate the effectiveness of these strategies. Additionally, Community Care demonstrated strong performance on the PA‑specific 7‑ and 30‑day follow‑up measures, with both rates improving and meeting their respective short‑term targets. Community Care will continue to complete a Root Cause Analysis on these follow-up rates, with the next one anticipated to be submitted to OMHSAS in June 2026.

In summary, although the 7‑ and 30‑day follow‑up rates have not met their goals and disparities persist, the PA‑specific rates showed improvement, and several interventions have demonstrated effectiveness, including for Black members. Continued implementation of these strategies is expected to improve follow‑up performance over time.

The QI Program always considers your safety in its measurement activities. We are very concerned about the continuity and coordination of care because it is an important member safety issue. Collaboration between providers is essential for safe and effective behavioral health treatment and can improve member outcomes. Exchange of information is encouraged between both behavioral and physical health providers to enhance members’ safety and well-being. We measure to be sure that when members receive care from more than one provider, both providers exchange information as appropriate. We encourage members to share treatment and medication information with all of their providers to help ensure safety. This is important when members are prescribed psychotropic medications or if they have physical health issues or other physical concerns, such as smoking or obesity, along with their behavioral health condition. Our Consent to Release Information form is available on our website for you to download and use. Please visit Provider Resources on ccbh.com for many other forms you will find useful.

If you would like to learn more about Community Care’s QI Program or our progress in meeting our goals, please call or write to us. If you would like a copy of our QI policy, we will send it to you. If you have suggestions for improving our QI Program, please let us know. If you would like to serve on the Provider Advisory Committee, please let us know.

For more information, to make a suggestion, to request a copy of the Quality Improvement Program or to participate on the Provider Advisory Committee, call us toll-free at 1-888-251-2224.

You can also write us at:

Community Care Behavioral Health

Quality Management Department

U.S. Steel Tower, Floor 8

600 Grant Street

Pittsburgh, PA 15219

We are pleased to offer you our infographic Quality in Numbers for CY 2024. Review it here: 2024 Quality in Numbers 

Review the Annual Executive Summary here: Executive Annual Summary