Follow-Up After High-Intensity Care for Substance Use Disorder

Identifying Attributes

Care Settings
Care Transitions
Country
United States of America
Publishing Organisation
National Committee for Quality Assurance (NCQA): Healthcare Effectiveness Data and Information Set (HEDIS)
Type of Quality Indicator
Process
IOM Quality Dimension
Timeliness
Domain
Follow-Up

Defining Attributes

Definition

The percentage of acute inpatient hospitalisations, residential treatment or withdrawal management visits for a diagnosis of substance use disorder among members 13 years of age and older that result in a follow-up visit or service for substance use disorder. Two rates are reported: 1. The percentage of visits or discharges for which the member received follow-up for substance use disorder within the 30 days after the visit or discharge
2. The percentage of visits or discharges for which the member received follow-up within 7 days of the ED visit.

Numerator

The number of acute inpatient hospitalisations, residential treatment or withdrawal management visits for a diagnosis of substance use disorder among members 13 years of age and older that result in a follow-up visit or service for substance use disorder. Two rates are reported: 1. The number of visits or discharges for which the member received follow-up for substance use disorder within the 30 days after the visit or discharge
2. The number of visits or discharges for which the member received follow-up within 7 days of the ED visit.

Denominator

The number of acute inpatient hospitalisations, residential treatment or withdrawal management visits for a diagnosis of substance use disorder among members 13 years of age and older.

Exclusions
Use of Risk Adjustment
No
Risk Adjustments
Stratifications

Collection and Reporting Attributes

Type of Data Collection
Surveys
Data Collection Methods

HEDIS survey results directly from health plans and Preferred Provider Organisations (PPOs) through the Healthcare Organisation Questionnaire and non-survey data through the Interactive Data Submission System.

Frequency of Data Collection
Annually
Frequency of Data Collection in Days
365
Reporting Methods

NCQA website - National averages (Publicly available)

Reporting Frequency
Annually
Reporting Frequency in Days
365
Indicator Has Recommended Targets
No

Source and Reference Attributes

Technical Specifications
Link to Measurement Tools
Quality Indicator Confirmed to be Part of a Program Used to Monitor Quality and Safety of Care Among Older People at a Population-Level between 2012-2022
No
Assessed by the Australian Consortium for Aged Care Collaborators as Generally Containing Good Properties (Importance and Scientific Acceptability)
No
Australian Consortium for Aged Care Endorsed
No
Can the Quality Indicator be Readily Implemented at a Population Level in Australia Given its Current Data Landscape?
Implementation of this quality indicator was not assessed.
Identified by PHARMA-Care Project
No
Upload Date
31 March 2026