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Engagement in Community-Based Mental Health Care After a Mental Health Hospitalization

CBE ID
3747
Endorsement Status
1.1 New or Maintenance
Previous Endorsement Cycle
Is Under Review
No
E&M Cycle Comments

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.

 

1.3 Measure Description

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.

        • 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.

        • 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.

        • 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.

        • OLD 1.12 MAT output not attached
          Attached
        • Most Recent Endorsement Activity
          Prevention and Population Health Spring 2023
        • Steward
          New York State Office of Mental Health
          Steward Organization POC Email
              • Risk adjustment approach
                Off
                Risk adjustment approach
                Off
                Conceptual model for risk adjustment
                Off
                Conceptual model for risk adjustment
                Off