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A partial hospitalization program (PHP) is an intensive outpatient treatment for a range of psychiatric conditions, including substance use disorders. They act as an intermediate level of care between inpatient admission and outpatient clinics, offering an alternative if outpatient sessions aren’t enough [1]. Your health insurance will usually cover a PHP; however, your exact coverage will depend on your specific plan. This article will provide more information on how partial hospitalization programs work and who may benefit from them.
- A partial hospitalization program (PHP) provides outpatient intensive psychiatric support for those with mental health conditions. They are for people who are at risk of needing an inpatient psychiatric admission or for those needing a ‘step down’ following an inpatient psychiatric stay.
- The cost varies depending on the program and location, but a PHP is generally covered by health insurance.
- After completing a PHP, it is important to have ongoing aftercare support, such as outpatient therapy or support groups.
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What is a partial hospitalization program?
A PHP is an intensive outpatient mental health treatment program [2]. You will typically spend several hours each day at the hospital but without staying overnight. They average 20 hours per week of treatment, providing more support than standard outpatient care [1].
PHPs can be tailored to specific conditions, and they involve a multidisciplinary team of professionals, including psychiatrists and social workers. Their length varies from a few days to several months, depending on the specific program. They are also used as a ‘step down’ following an inpatient hospital stay, supporting you in your adjustment back into normal life.
Benefit of PHPs
Partial hospitalization programs are an alternative between typical inpatient and outpatient treatments [3]. They offer intensive treatment without an inpatient stay, allowing you to maintain some normality in your life. Research has shown PHPs to be effective for many different conditions, including opioid use disorder [4].
How does a partial hospitalization program work?
After enrolling, you will have a timetable of structured activity, such as counseling sessions, educational classes, or group therapy sessions. Whilst the number of hours and the length of PHPs vary, having a more intensive timetable of treatments than standard outpatient care may help you see results sooner.
PHP vs. Other treatment options
PHPs provide more comprehensive mental health care than outpatient clinics, but they offer more flexibility than an inpatient stay, allowing you to still see loved ones and continue your hobbies alongside treatment. PHPs also offer more support than Intensive Outpatient Programs (IOPs), making them ideal for those requiring more structured care for their mental health.
Who should consider PHPs?
If outpatient care is not enough to help support your mental health needs, then a PHP might be suitable for you. Some reasons why you might benefit from a PHP include:
- Your mental health symptoms are not being controlled despite outpatient clinics.
- You struggle to complete daily tasks due to your mental health.
- You are worried about having a mental health relapse.
Cost and insurance coverage for partial hospitalization
PHPs are a cost-effective alternative compared to an inpatient stay. The cost varies depending on the location and specifics of your program, but it could be anywhere from $200 to $600 per day. However, due to the Affordable Care Act (ACA) stating that mental health is an essential health benefit, many insurance plans will cover a PHP. [5]
Medicare and Medicaid coverage for PHP
Medicare and some Medicaid plans cover a PHP, as long as the doctor and partial hospitalization program agree it’s necessary for you [6]. The coverage is through Medicare Part B, and once you meet the Part B deductible, you will also pay coinsurance for each day you’re enrolled in the PHP. Insurance coverage can vary a lot, so ensure you know the specifics of your plan and make sure the mental health professional you want to work with accepts Medicare or your specific plan.
There are certain things that insurance won’t cover though, such as:
- Transport to the PHP
- Meals
- Support groups
- Training for jobs
Admission requirements for PHPs
You're generally eligible for a PHP if you’re at risk of an inpatient psychiatric admission or if you’re transitioning from inpatient to community care. If your medical or mental health professional feels a PHP would suit you, they can refer you. After deciding to start a PHP, you can apply directly to the program. A PHP representative will then contact you to get more information about your condition and help recommend the program best suited to you.
Once you have enrolled, you’ll need to agree to attend the medical center for a certain number of hours each day. This may involve having to take a period of absence from your job or school, as well as household responsibilities, so you need to ensure you can make this time commitment.
Transitioning from PHP to other levels of care
Once you complete your PHP, continued treatment is vital to maintain progress. There are various ‘step down’ options, including:
- Intensive Outpatient Programs (IOPs), which are similar to PHPs but less intense, generally only require you to attend a few times per week.
- Outpatient therapy involves scheduled mental health appointments at varying frequencies based on your needs.
- Support groups, which meet regularly and serve as emotional support in the maintenance phases of treatment.
Finding the right partial hospitalization program
Finding the right PHP for you can feel like a challenge. It is important to consider the following:
- Location
- Qualifications of the medical professionals
- Available treatment options
- Aftercare support
- Insurance acceptance
We have a directory of facilities to help you find the right one for you. You can search for outpatient centers and then use the filter on the left-hand side to select ‘outpatient partial hospitalization’.
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