The percentage of discharges for members 6 years of age and older who were hospitalized for treatment of selected mental illness or intentional self-harm diagnoses and who had a follow-up visit with a mental health provider. Two rates are reported:
1. The percentage of discharges for which the member received follow-up within 30 days after discharge.
2. The percentage of discharges for which the member received follow-up within 7 days after discharge.
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1.5 Measure Type1.7 Electronic Clinical Quality Measure (eCQM)1.8 Level Of Analysis1.9 Care Setting1.20 Testing Data Sources
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1.14 Numerator
30-Day Follow-Up: A follow-up visit with a mental health provider within 30 days after discharge.
7-Day Follow-Up: A follow-up visit with a mental health provider within 7 days after discharge.
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1.15 Denominator
Discharges from an acute inpatient setting with a principal diagnosis of mental illness or intentional self-harm on the discharge claim during the first 11 months of the measurement year (i.e. January 1 to December 1) for members 6 years and older.
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Exclusions
Exclude from the denominator for both rates, members who begin using hospice services anytime during the measurement year (Hospice Value Set)
Exclude both the initial discharge and the readmission/direct transfer discharge if the readmission/direct transfer discharge occurs after December 1 of the measurement year.
Exclude discharges followed by readmission or direct transfer to a nonacute facility within the 30-day follow-up period regardless of principal diagnosis.
Exclude discharges followed by readmission or direct transfer to an acute facility within the 30-day follow-up period if the principal diagnosis was not for mental health or intentional self harm.
These discharges are excluded from the measure because rehospitalization or transfer may prevent an outpatient follow-up visit from taking place.
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Most Recent Endorsement ActivityEndorsed Behavioral Health and Substance Use Fall Cycle 2020Initial EndorsementLast Updated
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© 2020 by the National Committee for Quality Assurance
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Risk Adjustment
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6.1.2 Current or Planned Use(s)
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Use In Federal Program
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