Percentage of Medicaid discharges, ages 18 to 64, being treated for a substance use disorder (SUD) from an inpatient or residential provider that received SUD follow-up treatment within 7 or 30 days after discharge. SUD follow-up treatment includes outpatient, intensive outpatient, or partial hospitalization visits; telehealth encounters; SUD medication fills or administrations; or residential treatment (after an inpatient discharge). Two rates are reported: continuity within 7 and 30 days after discharge.
Medicaid discharges, ages 18 to 64, with a principal/primary substance (SUD) diagnosis treated at an inpatient or residential provider that received SUD follow-up treatment within 7 or 30 days after discharge. SUD treatment includes outpatient, intensive outpatient, or partial hospitalization visits; telehealth encounters; or SUD medication fills or administrations; or residential treatment (after an inpatient discharge. Two rates are reported: continuity within 7 and 30 days after discharge.
Denominator
1.15 Denominator
The denominator are Medicaid beneficiaries, ages 18-64, discharged from inpatient or residential provider with a principal diagnosis of SUD on the inpatient/residential treatment encounter claim.
Exclusions
Exclusions
Dual eligible Medicare/Medicaid beneficiaries are excluded. Rationale: Individuals who are covered under Medicare would receive coverage for follow-up treatment medications (e.g. opioid use disorder medications) under Medicare Part D and Medicare Part D claims are not captured in Medicaid claims databases. Therefore follow-up treatment would be missed.
Measure Record
Most Recent Endorsement Activity
Endorsed Behavioral Health and Substance Use Fall Cycle 2020
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