Quality Improvement with Benchmarking (external benchmarking to multiple organizations)

The percentage of emergency department (ED) visits for members 13 years of age and older with a principal diagnosis of alcohol or other drug (AOD) abuse or dependence, who had a follow up visit for AOD. Two rates are reported:
- The percentage of ED visits for which the member received follow-up within 30 days of the ED visit (31 total days).
- The percentage of ED visits for which the member received follow-up within 7 days of the ED visit (8 total days).

The percentage of emergency department (ED) visits for members 6 years of age and older with a principal diagnosis of mental illness or intentional self-harm, who had a follow-up visit for mental illness. Two rates are reported:
- The percentage of ED visits for which the member received follow-up within 30 days of the ED visit (31 total days).
- The percentage of ED visits for which the member received follow-up within 7 days of the ED visit (8 total days).

The percentage of discharges for patients 18 years of age and older who had a visit to the emergency department with a primary diagnosis of mental health or alcohol or other drug dependence during the measurement year AND who had a follow-up visit with any provider with a corresponding primary diagnosis of mental health or alcohol or other drug dependence within 7- and 30-days of discharge.

Four rates are reported:
- The percentage of emergency department visits for mental health for which the patient received follow-up within 7 days of discharge.

Percentage of ambulatory care sensitive Emergency Department (ED) visits for dental caries among children 0 – 20 years in the reporting period for which the member visited a dentist within (a) 7 days and (b) 30 days of the ED visit.

The percentage of discharges for individuals 18 – 64 years of age who were hospitalized for treatment of schizophrenia and who had an outpatient visit, an intensive outpatient encounter or partial hospitalization with a mental health practitioner. Two rates are reported.
•The percentage of individuals who received follow-up within 30 days of discharge
•The percentage of individuals who received follow-up within 7 days of discharge

Percentage of new antipsychotic prescriptions for Medicaid beneficiaries age 18 years and older who have completed a follow-up visit with a provider with prescribing authority within four weeks (28 days) of prescription of an antipsychotic medication.

Percentage of all pediatric (less than18 years) patients receiving in-center hemodialysis or home (irrespective of frequency of dialysis) with documented monthly adequacy measurements (spKt/V) or its components in the calendar month.

The percentage of Medicaid deliveries that had the following number of expected prenatal visits:

• less than 21 percent of expected visits.

• 21 percent–40 percent of expected visits.

• 41 percent–60 percent of expected visits.

• 61 percent–80 percent of expected visits.

• greater than or equal to 81 percent of expected visits.

Change in rasch derived values of mobility function from admission to discharge among adults aged 18 and older receiving inpatient medical rehabilitation at a post acute care facility who were discharged alive. The timeframe for the measure is 12 months. The measure includes the following 4 mobility items:1. Transfer Bed/Chair/Wheelchair, 2. Transfer Toilet, 3. Locomotion, 4. Stairs.

Change in rasch derived values of mobility function from admission to discharge among adult LTAC patients aged 18 years and older who were discharged alive. The time frame for the measure is 12 months. The measure includes the following 4 mobility items:Transfer Bed/Chair/Wheelchair, Transfer Toilet, Locomotion and Stairs.