Follow-Up Care for Adult Medicaid Beneficiaries Who Are Newly Prescribed an Antipsychotic Medication

Identifying Attributes

Care Settings
Care Transitions
Country
United States of America
Publishing Organisation
Centers for Medicare & Medicaid Services (CMS): Medicaid Innovation Accelerator Program
Type of Quality Indicator
Process
IOM Quality Dimension
Safety
Domain
Follow-Up

Defining Attributes

Definition

Percentage of new antipsychotic prescriptions for Medicaid beneficiaries age 18 years and older who have completed a follow-up visit with a provider with prescribing authority within four weeks (28 days) of prescription of an antipsychotic medication.

Numerator

The number of new antipsychotic medication prescriptions with a qualifying outpatient visits within 28 days (4 weeks) of the prescription fill date.

Denominator

New antipsychotic prescriptions for Medicaid beneficiaries age 18 years and older.

Exclusions

Medicaid beneficiaries with an acute inpatient admission during the four-week follow-up period after prescription of an antipsychotic medication Patients who expired within four weeks of new prescription date.

Use of Risk Adjustment
No
Risk Adjustments

None

Stratifications

Collection and Reporting Attributes

Type of Data Collection
Data Collection Methods
Frequency of Data Collection
This measure is intended for voluntary use by states to monitor and improve the quality of care provided for Medicaid beneficiaries. States may choose to utilize the measures based on their programmatic needs.
Frequency of Data Collection in Days
Reporting Methods

Not on care compare. Measure data will be reported annually (12 months). To account for the follow-up period following a new antipsychotic prescription, the denominator period will start January 1 and end November 30 of the measurement year. The measure includes a 120 day (four month) look-back period to establish "new" antipsychotic prescriptions.

Reporting Frequency
Reporting Frequency in Days
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