Tips to Improve Behavioral Health Outcomes and Close Care Gaps

Opportunity to Close Substance Use Disorder (SUD) Care Gap Measures

Review these resources for Initiation and Engagement of Substance Use Disorder Treatment (IET) and Follow-Up After Emergency Department Visit for Substance Use (FUA).

Fast, Flexible Follow-Up with Telehealth

Telehealth makes it easier to deliver timely care and stay connected to your patients. 

• Complete 7-day follow-up visits 
• Provide bridge care until a visit is available 

Key benefits 

• Telehealth counts toward Behavioral Health (BH) measures
• Supports your Overall Quality Score 
• Access in-network virtual providers (jump to list below→)

Close Gaps in Care with Medication-Assisted Treatment (MAT)

Medication-Assisted Treatment (MAT) is a proven, evidence-based approach for treating substance use disorders—supporting both recovery and quality measure compliance. 

Start the conversation—encourage patients to consider MAT as part of their recovery plan. 

• Explain how medications support long-term recovery
• Review available treatment options
• Reinforce the importance of follow-up and adherence

Take Action Today

Use these steps to improve outcomes and meet quality measures: 

• Identify patients with open gaps
  Log in to the Healthfirst provider portal to access the Care Opportunities tab in the Healthfirst Quality App

• Use telehealth for follow-up care
  Deliver timely care and maintain engagement
  

• Prescribe or continue MAT, when appropriate
  Initiating or maintaining MAT (when prescribed and dispensed) supports recovery and helps close care gaps
  
  
• Leverage in-network virtual BH providers
  Expand access and support medication management

• Submit claims or supplemental data
  Ensure gaps are documented as closed

In-network, Virtual Behavioral Health Providers

The providers listed can help ensure patients are seen within the required seven-day quality measure, especially while awaiting follow-up within your network. 

Note: Ophelia offers virtual care for opioid use disorders, including medication management and ongoing support.

Alcohol Use Disorder Treatment Medications

Opioid Use Disorder Treatment Medications

Quality App

• Use the Quality App Guide to learn how to download Care Opportunity lists, review your earnings, and more.
• Reminder: Providers who access the Quality App at least once a month earn 2x more incentives on average compared to those who log in less than once a month.
  
  • Existing Availity Essentials Users: log in at essentials.availity.com
  • New Availity Essentials Users: If you do not have an account, register to gain access at availity.com/multi-payer-portal-registration

Need Additional Support?

• Call our Behavioral Health Care Management team at 1-844-892-6855, Monday to Friday, 9am–5pm. We can help connect patients to:
  • Case management for medical, behavioral, and social needs
  • Outpatient mental health and substance use disorder programs

• Quality-specific questions: email clinicalquality@healthfirst.org.

• General support: contact your Network Account Manager, or call Provider Services at 1-888-801-1660, Monday to Friday, 8:30am–5:30pm, with your Tax ID Number (TIN).

Coverage is provided by Healthfirst Health Plan, Inc., Healthfirst PHSP, Inc., and/or Healthfirst Insurance Company, Inc. (together, “Healthfirst”).