Identifying those who have not received an outpatient ambulatory medical visit in 6 months or more, and then creating a list.
We account for those who have an upcoming appointment scheduled and then call each individual to try and schedule and appointment. If we cannot reach the individual because of a phone number that no longer is working, we turn them over to our Medical Case Managers to try and find contact information.
Sometimes the individual has moved out of the service area, changed phone numbers, etc. This information is updated. Individuals who are on the final list are those who have not been seen in 6 months or more, and have no upcoming appointment scheduled, and for some reason will not schedule or cannot be contacted.
This list is transferred to our State Bridge Counselor to try and reengage these individuals. The list usually begins with over 100 names...and the final list given to the State Bridge Counselor is paired down to about 3-5 times every two months. This QI initiative keeps people in care before they go anymore than 180 days without an appointment and allows us to stay ahead of the retention curve.
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