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.
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.
Denominator
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.
Exclusions
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.
Measure Record
Most Recent Endorsement Activity
Endorsed Behavioral Health and Substance Use Fall Cycle 2020
Public Comments