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 at least five follow-up community-based mental health care visits in the 90 days after discharge.
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1.14 Numerator
Discharges must receive five or more follow-up visits with a community-based mental health care provider within 90 days after discharge for inpatient treatment of select mental health or intentional self-harm diagnoses.
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1.15 Denominator
Acute inpatient discharges ages 6-64 principally hospitalized for select mental illnesses or intentional self-harm and enrolled in Medicaid on the date of discharge through 90 days after discharge.
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Exclusions
In addition to the discharges with acute direct transfers, certain acute readmissions, non-acute direct transfers, and non-acute readmissions detailed above, discharges who are dually enrolled in Medicare and Medicaid and discharges in hospice or using hospice services anytime during the measurement year are excluded.
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OLD 1.12 MAT output not attachedAttached
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Most Recent Endorsement ActivityPrevention and Population Health Spring 2023
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StewardNew York State Office of Mental HealthSteward Organization POC Email
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Risk AdjustmentRisk adjustment approachOffRisk adjustment approachOffConceptual model for risk adjustmentOffConceptual model for risk adjustmentOff
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6.1.2 Current or Planned Use(s)6.1.3 Current Use(s)
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Effective March 27, 2023, the National Quality Forum (NQF) is no longer the consensus-based entity (CBE) funded through the Centers for Medicare & Medicaid Services (CMS) National Consensus Development and Strategic Planning for Health Care Quality Measurement Contract. Battelle has been selected to oversee the endorsement & maintenance (E&M) of clinical quality and cost/resource use measures. Since the Spring 2023 cycle launched at NQF, measures submitted to this E&M cycle continued along the prior E&M protocols that were in place at time of the Spring 2023 “Intent to Submit.” Battelle took over the E&M work for the Spring 2023 cycle when developers and/or stewards submitted their full measure information, which for CBE #3747, the most recent measure specifications can be found here: https://p4qm.org/sites/default/files/2023-06/3747_-_engagement_in_community-based_mental_health_care_after_a_mental_health_hospitalization.zip
To close out this E&M cycle, Battelle published the Spring 2023 measures for pre-evaluation public commenting, convened the E&M standing committees for their measure evaluation meetings, launched the Spring 2023 post-comment period, convened the E&M committees for the post-comment meeting, convened the CSAC to render a final endorsement decision, and executed the appeals period.