Behavioral health conditions

Quality measures

HEDIS healthcare performance measures

What is HEDIS?

Designed by the National Committee for Quality Assurance (NCQA), the Healthcare Effectiveness Data and Information Set (HEDIS®) is a collection of over 90 measures consisting of various evidence-based clinical guidelines for services rendered to commercial, Medicare and Medicaid HMO, POS and PPO plan members. More than 90 percent of America's health plans use this tool to measure performance on critical dimensions of care and service.   

HEDIS measures that are specific to behavioral health: 

  1. ADD: Follow-Up Care for Children Prescribed Medication for Attention Deficit Hyperactivity Disorder (ADHD)
  2. FUH: Follow-Up after Hospitalization for Mental Illness
  3. FUM: Follow-Up After Emergency Department Visit for Mental Illness
  4. FUA: Follow-Up After Emergency Department for Substance Use
  5. IET: Initiation and Engagement of Alcohol & Other Drug Dependence Treatment.

The ADD measure is linked to medications, while the IET measure is linked to substance use disorder and treatment. The FUH, FUM and FUA measures are linked to increasing care between inpatient and outpatient treatment.

 

Your assistance in helping us uphold the high quality demanded by HEDIS through monitoring and compliance goes a long way in allowing us to continue to serve your patients in the most effective way possible. We offer a variety of resources (in the box to the right) to guide you in this process.