Screening patients for depression is an important part of outpatient visits. We created a video about depression screening tools, procedure codes and following up on positive screening. You can watch the video here.
We encourage you to talk with our members about mental health and getting help if needed. More than half of Americans will be diagnosed with a mental illness or disorder at some point in their lives, according to the . Patients often rely on their primary care physicians for behavioral health care, according to the .
Supporting Quality Behavioral Health Care
We track claims data for quality measures to help assess and improve our members’ behavioral health care. See our tip sheets to learn more about the following measures and closing gaps in members’ care:
AMM captures the percentage of members ages 18 and older with major depression who are newly treated with antidepressant medication and remain on it. We track two treatment phases:
- Effective acute treatment phase: Adults who remain on antidepressant medication for at least 84 days (12 weeks)
- Effective continuation treatment phase: Adults who remain on antidepressant medication for at least 180 days (six months)
FUH applies to members ages 6 and older who had a follow-up visit with a mental health provider after they were hospitalized for the treatment of mental illness or intentional self-harm. FUH captures the percentage of discharges for which members had a follow-up visit:
- Within 30 days of discharge (31 total days)
- Within seven days of discharge (eight total days)
FUM captures the percentage of emergency department visits for which members ages 6 and older with a diagnosis of mental illness or intentional self-harm had a follow-up visit:
- Within 30 days of the emergency department visit (31 total days)
- Within seven days of the emergency visit (eight total days)
SSD tracks the number of people 18 to 64 years old with schizophrenia or bipolar disorder who were dispensed an antipsychotic medication and had an annual diabetes screening.
The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.
HEDIS is a registered trademark of NCQA.