Behavioral Health Care

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Behavioral Health Care

• Adherence to Antipsychotic Medications for Individuals With Schizophrenia (SAA)
• Community Hospital Discharges for Mental Health-Related Conditions - Follow-up Visit within 30 Days of Discharge
• Community Hospital Discharges for Mental Health-Related Conditions - Follow-up Visit within 7 Days of Discharge
• Community Hospital or APRT Readmissions for Mental Health Conditions at 180 Days
• Community Hospital or APRT Readmissions for Mental Health Conditions at 30 Days
• Community Hospital Readmissions for Mental Health-Related Conditions within 180 Days of Discharge
• Community Hospital Readmissions for Mental Health-Related Conditions within 30 Days of Discharge
• Comprehensive Diabetes Care: People with Serious Mental Illness - HA1c Testing Poor Control (>9%) (HPCMI, CMS Adult Core Set)
• Concurrent Use of Opioids and Benzodiazepines (CUOB, CMS Adult Core Set)
• Diabetes Monitoring for People With Diabetes and Schizophrenia (SMD)
• Engagement of Alcohol Abuse or Dependence Treatment (IET)
• Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (IET)
• Engagement of Opioid Abuse or Dependence Treatment (IET)
• Engagement of Other Drug Abuse or Dependence Treatment (IET)
• Follow-up After Emergency Department Visit for Mental Illness (FUM) Within 30 days by Age
• Follow-up After Emergency Department Visit for Mental Illness (FUM) Within 7 days by Age
• Initiation of Alcohol Abuse or Dependence Treatment (IET)

• Initiation of Alcohol and Other Drug Abuse or Dependence Treatment (IET)
• Initiation of Opioid Abuse or Dependence Treatment (IET)
• Initiation of Other Drug Abuse or Dependence Treatment (IET)
• NH Hospital Discharges - Discharge Plan Provided to Aftercare Provider within 7 Calendar Days of Member Discharge
• NH Hospital Discharges - Follow-up Visit within 30 Days of Discharge
• NH Hospital Discharges - MCO Contacts and Contact Attempts
• NH Hospital Discharges - New CMHC Patient Had Intake Appointment with CMHC within 7 Calendar Days of Discharge
• Readmissions for Mental Health Conditions within 30 Days
• Readmissions to NH Hospital within 30 Days
• Risk of Continued Opioid Use >= 15 Days by Age
• Risk of Continued Opioid Use >= 30 Days by Age
• Screening for Clinical Depression and Follow-Up Plan (CDF, CMS Adult and Child Core Set)
• Use of Opioids at High Dosage (HDO)
• Use of Opioids from Multiple Providers (UOP): Multiple Pharmacies
• Use of Opioids from Multiple Providers (UOP): Multiple Prescribers
• Use of Opioids from Multiple Providers (UOP): Multiple Prescribers and Multiple Pharmacies

Behavioral Health Care - Adults

• Community Hospital Discharges for Mental Health-Related Conditions - Follow-up Visit within 7 Days of Discharge
• Community Hospital Readmissions for Mental Health-Related Conditions within 180 Days of Discharge

• Community Hospital Readmissions for Mental Health-Related Conditions within 30 Days of Discharge

Behavioral Health Care - Children

• Community Hospital Discharges for Mental Health-Related Conditions - Follow-up Visit within 7 Days of Discharge
• Community Hospital Readmissions for Mental Health-Related Conditions within 180 Days of Discharge
• Community Hospital Readmissions for Mental Health-Related Conditions within 30 Days of Discharge
• Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM) - Blood Glucose and Cholesterol Testing

• Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM) - Blood Glucose Testing
• Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM) - Cholesterol Testing
• Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP)

Behavioral Health Care - Older Adults

• Community Hospital Readmissions for Mental Health-Related Conditions within 180 Days of Discharge

• Community Hospital Readmissions for Mental Health-Related Conditions within 30 Days of Discharge

Behavioral Health Care - Special Needs Population

• Community Hospital Readmissions for Mental Health-Related Conditions within 180 Days of Discharge

• Community Hospital Readmissions for Mental Health-Related Conditions within 30 Days of Discharge

HEDIS Behavioral Health Care Measures

• Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM) - Blood Glucose and Cholesterol Testing
• Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM) - Blood Glucose Testing

• Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM) - Cholesterol Testing

Substance Use Disorder Care

• Member Retention in SUD Treatment

• Safety Monitoring - Opioid Prescriptions Meeting NH DHHS Morphine Equivalent Dosage Prior Authorization Compliance