Follow-Up After Hospitalisation for Mental Illness (7-Day and 30-Day Follow-Up )

Identifying Attributes

Care Settings
Care Transitions
Country
United States of America
Publishing Organisation
Centers for Medicare & Medicaid Services (CMS): Marketplace Quality Rating System
Type of Quality Indicator
Process
IOM Quality Dimension
Timeliness
Domain
Follow-Up

Defining Attributes

Definition

The percentage of discharges for members who were hospitalised for treatment of selected mental illness or intentional self-harm diagnoses and who had a follow-up visit with a mental health provider within 7 days and 30 days after discharge. Age stratification :65 years and older.

Numerator

A follow-up visit with a mental health provider within 7 days and 30 days after discharge. Do not include visits that occur on the date of discharge. any of the following meet criteria for a follow-up visit: • An outpatient visit with a mental health provider. • An outpatient visit with a mental health provider. • An intensive outpatient encounter or partial hospitalisation • An intensive outpatient encounter or partial hospitalisation • A community mental health centre visit • Electroconvulsive therapy • A telehealth visit with a mental health provider. • An observation visit with a mental health provider. • Transitional care management services with a mental health provider. • A visit in a behavioural healthcare setting • A telephone visit with a mental health provider. • Psychiatric collaborative care management.

Denominator

Patients 6 years of age and older who were discharged from an acute inpatient setting (including acute care psychiatric facilities) with a principal diagnosis of mental illness or intentional self-harm on or between January 1 and December 1 of the measurement period.

Exclusions

Patients who use hospice services any time during the measurement period, Clinician documented reason patient was not able to complete 30 day follow-up from acute inpatient setting discharge (e.g., patient death prior to follow-up visit, patient non-compliant for visit follow-up).

Use of Risk Adjustment
No
Risk Adjustments

None

Stratifications

Report three age stratifications and a total rate: • 6–17 years. • 18–64 years. • 65 years and older. • Total.

Data Attributes

Type of Data Collection
Administrative data
Data Collection Methods

Claims Data.

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

Reported on National Committee for Quality Assurance website (not publicly available) www.ncqa.org/hedis/health-plan-ratings/

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

Source and Reference Attributes

Evidence Source
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
Yes
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
Identified by PHARMA-Care Project
No
Upload Date
12 March 2025