Department of Vermont Health Access - Medicaid Global Commitment (Mental Health) and 1 more...less...

Vermont Medicaid (GC-17)

FUH: Follow Up After Hospitalization for Mental Illness - within 7 days* (GC-17)


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Notes on Methodology
  • The annual reported rate captures activity during the previous calendar year.  For example, the 2017 rate captures services provided during calendar year 2016.
  • This is a Healthcare Effectiveness & Data Information Set (HEDIS) administrative measure.
    • Through data analysis performed in 2014 during the FUH 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.
  • Based on the advice of their External Quality Review Organization (EQRO), DVHA’s rates only include only Medicaid Primary beneficiaries in HEDIS administrative measures as of 2014.
  • The target trend line is the 50th percentile national benchmark for Medicaid programs.

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

Story Behind the Curve

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 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 2017

Author:  DVHA Quality Unit

What Works

•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.

Action Plan

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.

Scorecard Result Container Indicator Measure Action Actual Value Target Value Tag S R I P PM A m/d/yy m/d/yyyy