Market Education

Continuum of Care Model in TIER Workflow

The TIER® service delivery component is developed according to a continuum of care model consisting of four distinct levels of service defined by the expected intensity and duration of treatment services. Individuals with the most intensive treatment needs are assigned to Level 1 services, if the precipitating situation is expected to be resolved with only short-term treatment. If the need for intensive services is expected to continue for a longer duration, then Level 2 services are more appropriate. Level 3 services are designed to meet the needs of individuals who require prolonged, moderate, intensive treatment, and Level 4 services are designed for individuals whose conditions are generally stable and require low intensity services such as continuing care.

The continuum of care service delivery model is designed to be a flexible process that can address a broad range of patient clinical needs within the most appropriate level of service. Although utilization criteria are established for selecting a level of service, case managers may provide any appropriate level of service as required by the patient’s treatment plan. The required level of service should be initially designated via preadmission screening and the initial evaluation and treatment plan; and, when applicable, updated in the comprehensive treatment plan or continuing care plan. The scope of goals and objectives, type and frequency of therapeutic interventions, and overall complexity of the treatment plan varies with each level of service. The time frames for the required assessments and treatment plans also vary according to each level and service setting. Also, as patients’ clinical needs change, in response to treatment, the assigned level of service may be modified accordingly.

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