Refining the Utilization Management Process: 7 Ways to Support Smooth Service Transitions for Young Adults
Utilization Management (UM) is an essential administrative and clinical system in behavioral health care. It helps programs match patients with appropriate care, monitor capacity and length of stay, plan effective transitions and discharges, and identify disparities and delays as they occur.
Having a UM tool that supports transition planning is especially important for young adults aged 18-25. Many of these individuals, particularly those with complex behavioral health needs, face significant challenges moving from childhood to adult systems, which often leads to delays or discontinuation of services.
The risk of losing access to care during this critical transition is even higher for young people with co-occurring disorders, marginalized identities, and/or prior involvement in child welfare or juvenile systems. On top of these individual challenges, structural barriers—such as unstable housing, gaps in or lack of insurance coverage, limited accessibility and affordability, uncertain employment or education status, immigration concerns, and legal issues—can make it even harder for young adults to remain connected to treatment at any stage.
To inform our Quality Improvement (QI) project for the Connecticut Department of Mental Health and Addiction Services' Young Adult Services (YAS) division, CHDI Senior Project Coordinator Meghan Flynn, PhD, conducted a literature review to identify best practices in Utilization Management for young adults.
Here’s what we found—the top seven strategies that stand out most for supporting smooth, effective transitions in care.
Proactive transition planning
Rather than waiting until discharge, transition planning should begin at admission and continue through treatment in a developmentally appropriate way.
This can include development of a treatment timeline, clear conversations about next steps, opportunities to meet prospective providers, and structured handoffs, which have been shown to reduce anxiety, uncertainty, and disengagement.
Implement Life Skills Assessments
A young adult’s strengths and challenges with essential life skills—like personal care, managing a household, navigating the community, handling money and benefits, staying on top of health and medications, communicating effectively, and making decisions—should help shape their treatment plan. By assessing these abilities, providers can tailor support to each young person’s unique needs and goals.
However, it's important to remain aware that assessments can be biased and may not reflect skills needed to navigate the modern world, particularly technological skills.
Identify and address structural barriers
Structural barriers can affect all periods of a young adult's treatment, from admission to discharge.
Identifying the population you serve by collecting and tracking demographic data in addition to monitoring structural barriers can help mitigate these effects on treatment and determine which clients may be increasingly impacted by structural barriers based on their identity.
Further, the effects of these structural barriers can be mistaken for clinical needs. For instance, if an individual is discharged from a highly supportive environment, such as a residential setting, what may seem like a decline in functioning may in fact be a response to increased autonomy, reduced scaffolding, or greater exposure to structural barriers.
Collaborate across systems
Ongoing stability is dependent on the programs and resources a young adult can access post-discharge. For young adults with substance use disorders, interventions and community engagement are crucial, including peer support services, harm reduction approaches, and supportive housing.
Follow trauma-informed care principles
Ensure flexibility in service models
fdafdsa
Continuously revise with young adult feedback
fdsafdsa
Learn More About Quality Improvement
testesttest