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Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics

CBE ID
2801
Endorsement Status
1.1 New or Maintenance
Previous Endorsement Cycle
Is Under Review
No
Next Maintenance Cycle
Spring 2025
1.3 Measure Description

Percentage of children and adolescents 1-17 years of age who had a new prescription for an antipsychotic medication, but no U.S. Food and Drug Administration primary indication for antipsychotics, and had documentation of psychosocial care as first-line treatment.

        • 1.5 Measure Type
          1.7 Electronic Clinical Quality Measure (eCQM)
          1.8 Level Of Analysis
          1.20 Testing Data Sources
        • 1.14 Numerator

          Children and adolescents 1-17 years of age who had psychosocial care as first-line treatment prior to (or immediately following) a new prescription of an antipsychotic without a U.S. Food and Drug Administration primary indication for antipsychotic use.

        • 1.15 Denominator

          Children and adolescents 1-17 years of age as of December 31 of the measurement year who had a new prescription of an antipsychotic medication for which they do not have a U.S. Food and Drug Administration primary indication for antipsychotics.

        • Exclusions

          Exclude children and adolescents with a diagnosis of a condition for which antipsychotic medications have a U.S. Food and Drug Administration primary indication and are thus clinically appropriate: schizophrenia, schizoaffective disorder, bipolar disorder, other psychotic disorder, autism, or other developmental disorder.

          Patients in hospice.

        • OLD 1.12 MAT output not attached
          Attached
          1.13a Data dictionary not attached
          No
        • Most Recent Endorsement Activity
          Endorsed Behavioral Health and Substance Use Fall Cycle 2019
          Initial Endorsement
          Last Updated
        • Steward
          National Committee for Quality Assurance
          Steward Organization POC Email
          Steward Organization Copyright

          The HEDIS® measures and specifications were developed by and are owned by the National Committee for Quality Assurance (NCQA). The HEDIS measures and specifications are not clinical guidelines and do not establish a standard of medical care. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in these materials and can rescind or alter these materials at any time. These materials may not be modified by anyone other than NCQA. Anyone desiring to use or reproduce the materials without modification for a non-commercial purpose may do so without obtaining any approval from NCQA. All commercial uses must be approved by NCQA and are subject to a license at the discretion of NCQA. 

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          Calculated measure results, based on unadjusted HEDIS specifications, may not be termed “Health Plan HEDIS rates” until they are audited and designated reportable by an NCQA-Certified Auditor. Such unaudited results should be referred to as “Unaudited Health Plan HEDIS Rates.” Accordingly, “Heath Plan HEDIS rate” refers to and assumes a result from an unadjusted HEDIS specification that has been audited by an NCQA-Certified HEDIS Auditor. 

          Limited proprietary coding is contained in the measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. NCQA disclaims all liability for use or accuracy of any coding contained in the specifications. 

          Content reproduced with permission from HEDIS, Volume 2: Technical Specifications for Health Plans. To purchase copies of this publication, including the full measures and specifications, contact NCQA Customer Support at 888-275-7585 or visit www.ncqa.org/publications.

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                Conceptual model for risk adjustment
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                Conceptual model for risk adjustment
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