• The target trendline in the graph above represents an accepted national benchmark percentile for Medicaid programs across the country. The value graphed historically was the national 50^th percentile for comparison purposes. In 2020 (for measurement year 2019) we modified the value shown to demonstrate a target based on our actual performance.  For this measure, the target is the 90^th national percentile.  
• The age range for the actual trend line is for age 18+ and the age range for the target trendline is 18-64.  
• Previous to measurement year (MY) 2020 the age range for this measure was 21+. Starting in MY 2020 the age range changed to 18+ and was set as the new baseline.
• The annual reported rate captures activity during the previous calendar year. 
• This is a Healthcare Effectiveness & Data Information Set (HEDIS) adjusted administrative measure.
• Through data analysis performed in 2014 during our Follow-Up After Hospitalization for Mental Illness performance improvement project (PIP), Vermont Medicaid learned that administrative claims data alone was not capturing all of the follow-up care actually being provided. Follow-up visits at the Department of Mental Health's Designated Agencies (DA's) were not included in the rates prior to 2014. As you can see from the chart, once the DVHA Data Unit incorporated those mental health follow-up visits our rates rose considerably for Medicaid Primary beneficiaries.
• DVHA’s rates only include Medicaid Primary beneficiaries in HEDIS administrative measures.

This measure looks at continuity of care for mental illness. It measures the percentage of Medicaid beneficiaries 6 years of age and older who were hospitalized for selected mental disorders and who were seen on an outpatient basis by a mental health provider within 7 days or within 30 days after their discharge from the hospital. The Adult Core Set asks states to report the rate for the subset of members 21 years of age and older (shown above).  The specifications for this measure are consistent with guidelines of the National Institute of Mental Health and the Centers for Mental Health Services.

It is important to provide regular follow-up therapy to patients after they have been hospitalized for mental illness. An outpatient visit with a mental health practitioner after discharge is recommended to make sure that the patient’s transition to the home or work environment is supported and that gains made during hospitalization are not lost. It also helps health care providers detect early post-hospitalization reactions or medication problems and provide continuing care.

Last updated:  August 2021

•Medicaid beneficiaries and families
•Mental health practitioners
•Hospitals
•Department of Mental Health
•Department of Children and Families
•Department of Aging and Independent Living
•Vermont Department of Health

• Schedule follow-up appointments when a patient is discharged, as part of the treatment or case management plan.
• Educate patients and practitioners about the importance of timely follow-up visits.
• Consider reminder systems or “re-schedule” notices that are delivered to patients.
• Develop outreach systems or assign case managers to encourage recently discharged patients to keep follow-up appointments or reschedule missed appointments.

Vermont Medicaid continues to focus on improving follow-up after hospitalization for mental illness even though our formal Performance Improvement Project cycle ended in 2015. We are now participating in a joint payer project, lead by the Vermont Program for Quality in Healthcare, also with the goal of increasing the number of mental health follow-up appointments after an individual has been hospitalized for mental illness.