Spectrum Health Systems – Merrick St.

For thirty-nine years, Spectrum has been on the forefront of substance abuse and mental health treatment, helping thousands of individuals overcome addiction to lead satisfying and productive lives. Originally known as "Spectrum House," Spectrum was responsible for establishing one of the first therapeutic communities in the country for the treatment of drug abuse. Since the company's founding in 1969, Spectrum has grown considerably, broadening its array of services, expanding to other states, and developing specialized services to meet the unique needs of high-risk populations, including offender addicts and troubled youth.

In order to decrease no-shows, we scheduled a clinician to provide on-site services for 8 hours per week in 2 parole-populated recovery programs.

When the clinician only saw clients at our agency’s Merrick Street location, there was a 50 percent no-show rate for a caseload of 8 clients. We feel that seeing clients in the community will reduce no-shows due to scheduling and transportation issues.

As a result of these changes, the no-show rate decreased from 48 percent to zero.

Figure 1

During the three months prior to this change, 48 of 100 visits resulted in a no-show. In the three months after this change, the no-show rate for 98 visits was zero.
This reduction in no-shows effectively doubles (from 4 to 8) the number of clients seen and treated per week (208 additional client sessions per year).
Reducing no-shows in this way also increased our revenue by $256 per week ($13,312 per year) for individual client sessions billed at $64 each.

We learned a couple of things in the course of this Change Project:

• The clinician was receptive to seeing clients on site and it was not difficult to collaborate with community agencies to remove availability and transportation barriers.
  
• It’s important to work on insurance verification and billing issues to ensure maximum reimbursement for on-site services.

As a result of this Change Project, we’ve identified several next steps:

• We will continue to provide on-site services for this program and will also look to implement similar systems in collaboration with other community programs.
• We are monitoring the impact and sustainability of this change for its ability to meet client needs and to increase revenue and productivity.
• We are reviewing plans for the addition of on-site group treatment for relapse prevention.