National Council for Mental Wellbeing

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With the implementation of the Affordable Care Act, parity, and Medicaid expansion, more people than ever before will have access to treatment for mental health and addiction services through expanded public and private insurance coverage. By 2019, an additional 15 million people will be eligible to enroll in Medicaid; an additional 16 million people will be covered by private insurance. Mental health and addictions treatment organizations must gear up to meet the increased demand and face the competition — they must be able to offer appointments when people need them, avoid long waitlists, and improve operational efficiencies.

Organizations must understand that the longer patients have to wait to get appointments, the more likely they are to go to a different provider. While a same-day appointment has a 10% chance of not being kept, almost 25% of patients with next-day appointments cancel or simply do not show up. Offering same day access improves operational efficiencies, avoids revenue loss, and allows clinicians to spend more time engaging patients in treatment.


Since 2008, the National Council has offered behavioral health organizations the opportunity to participate in various Access and Retention initiatives. These initiatives are designed to provide the tools and resources to make access to care more timely, to address revenue losses due to no-show appointments, and to institute performance improvement measures across the board. Through our work with hundreds of community-based behavioral healthcare organizations nationwide, the National Council has proven that it is feasible to increase engagement in treatment by reducing the time it takes to enter care. We’ve seen that quick access to care improves continuity and more quickly engages patients.

Our consultants can help your organization assess current models of access-to-care process

flows and identify the types of barriers to effective access as they identify:

  • The number of processes, staff, and client time requirements; documentation requirements, including data collection redundancy; and the costing for each access-to-care flow process.
  • Use of objective flow charts, costing, and data mapping outcomes to increase awareness of change in access-to-treatment processes and practices that can improve access to services.
  • A standardized access-to-care process flow, including costing awareness.

We also help to implement results-oriented change techniques:

  • Streamline documentation: Help organizations reduce their documentation requirements by focusing on the removal of repetitively captured data elements and data elements that are not required by funding or accreditation organizations and changing the answer formats used to capture data elements to reduce overall documentation time.
  • Concurrent collaborative documentation: Eradicate post-session documentation time while increasing person-centered engagement of clients in their recovery by involving them in the creation of their clinical documentation.
  • Walk-in access models: Implement a zero no-show model to offer more expedient access to care and increased engagement.
  • No-show management: Use policy changes, policy enforcement, engagement specialists, and reminder back-filling programs to help clients increase their show rates and engagement levels.
  • Employee engagement and maximization of staff productivity: Help providers get staff to
  • buy in to change so that they can achieve their direct service staff’s productivity targets.

Organizations participating in the National Council’s Access and Retention initiatives have achieved unprecedented results:

  • Average of 60% reduction in consumer wait times — with greater engagement and reduced no-shows.
  • Average of 39% reduction in cost of access to treatment process and 34% reduction in staff time needed per access to treatment event.
  • Up to 50% reduction in the number of data elements collected.
  • Average of 9 hours per week in time saved per direct care staff on documentation.
  • Average 26% increase in intake capacity with no increase in number of staff
  • Average of over $200,000 in annual savings in access to care costs per organization


Stop Waste, Eliminate Wait

Read the National Council Magazine article “National Council Access Redesign Initiative Saves Agencies $200,000 a Year” by Scott Lloyd, Vice President, MTM Services

Access Redesign Project Summary
Learn how 45 community behavioral health organizations in three states cut patient wait times by more than half, reduced staff time by 40 percent, and saved an average of $222,000 annually.