NY Manual
SHP Manual

New York Provider Manual
9.2 Benefits and Access to Care | 9.4 Utilization and Medical Management Guidelines

9.3 Program Overview - Behavioral Health Care Management

The Behavioral Health Program provides an integrated, holistic care management solution for members with mental health and substance use disorders to effectively address acute, sub-acute, intermediate and long term care needs.  The Behavioral Health Program is designed to maximize quality of care while providing services in a cost-effective manner.
Healthfirst collaborates with network providers and community partners to offer comprehensive, integrated programs that address physical, behavioral health and social service needs across the entire continuum of care – prevention, early detection, acute/episodic illness, chronic illness, with an emphasis on long term recovery.
The Healthfirst Behavioral Health Program provides enhanced discharge planning and transitional care support to beneficiaries hospitalized for treatment of a mental health or substance use disorder and for beneficiaries with a chronic mental health or substance use disorder who are hospitalized due to a physical illness. Healthfirst case managers share information with the treatment team and link facility and community based providers to inform effective decision making. The case managers participate in discharge planning activities to effectuate an integrated discharge and treatment plan that considers needs for physical and behavioral health care and addresses social risks such as need for housing, legal assistance, financial resource to improve adherence, reduce readmission risk , increase community tenure, improve health outcomes.  Healthfirst also offers community based post mental health discharge bridge visits and peer services to provide enhanced transitional support to members at risk for readmission or poor health outcomes.