Continuous Improvement and the Expansion of Quality ... - NCQA

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T H E S TAT E o f H E A l T H C A R E Q U A l I T y 2 0 1 1 • H E D I S M E A S U R E S o f C A R E • Effective Continuation Phase Treatment. The percentage of newly diagnosed and treated people who remained on an antidepressant medication for at least 180 days (6 months). results Measurement of both rates will address the incomplete prescribing and use of antidepressants that contribute to negative economic, clinical and public health outcomes. 10 Improvements in antidepressant medication adherence will reduce the burden of relapse and reoccurrence. 11 yEAR aCutE PHasE CoMMERCIAl MEDICARE MEDICAID HMo PPo HMo PPo HMo 2010 64.7 64.3 65.0 67.4 50.7 2009 62.9 63.2 63.7 63.4 49.6 2008 63.1 63.1 62.5 61.6 48.2 2007 62.9 63.8 61.2 61.0 42.8 2006 61.1 63.6 58.2 56.7 42.9 2005 61.3 65.6 55.0 49.2 45.1 2004 60.9 NA 56.4 NA 46.4 2003 60.7 NA 53.3 NA 46.2 2002 59.8 NA 52.1 NA 47.5 2001 56.9 NA 51.2 NA 45.5 2000 57.4 NA NA NA NA 1999 58.8 NA NA NA NA yEAR ContInuatIon PHasE 69 CoMMERCIAl MEDICARE MEDICAID HMo PPo HMo PPo HMo 2010 48.3 48.1 51.9 55.7 34.4 2009 46.2 46.4 50.6 51.0 33.0 2008 46.3 46.4 49.3 48.9 31.8 2007 46.1 47.6 48.7 48.7 27.4 2006 45.1 46.6 45.1 40.9 27.5 2005 45.0 48.4 41.1 31.1 29.7 2004 44.3 NA 42.4 NA 30.4 2003 44.1 NA 39.2 NA 29.3 2002 42.8 NA 37.7 NA 32.4 2001 40.1 NA 36.8 NA 30.0 2000 40.1 NA NA NA NA 1999 42.1 NA NA NA NA C H R o N I C D I S E A S E M A N A G E M E N T
C H R o N I C D I S E A S E M A N A G E M E N T 70 In 2009, an estimated 21.8 million persons 12 or older were classified with substance dependence or abuse. of these, 70 percent were dependent on or abused alcohol, 15 percent abused or were dependent on both alcohol and illicit drugs and 16 percent were dependent on or abused illicit drugs. 1,2 The Initiation and Engagement of Alcohol and Other Drug Dependence Treatment measure monitors whether adolescents and adult members with an episode of alcohol or drug dependence initiated and followed up on necessary treatment. • The primary goals of drug abuse or addiction treatment are abstinence, relapse prevention and rehabilitation. less than 20 percent of people diagnosed with substance abuse and less than 40 percent of those with addiction problems seek treatment. 3 • one in four deaths in the U.S. is attributed to alcohol, tobacco or illicit drugs. 6 the Case for Improvement • Total overall costs of substance abuse in the U.S., including productivity, health and crime-related costs, exceed $600 billion annually. Every American adult pays nearly $1,000 per year for the damages of addiction. 4,5 N AT I o N A l C o M M I T T E E f o R Q U A l I T y A S S U R A N C E INITIATIoN AND ENGAGEMENT of AlCoHol AND oTHER DRUG DEPENDENCE TREATMENT • The health burden of substance use includes the harmful effects of acute intoxication, substance use-associated injury and violence and the consequences of numerous medical and psychiatric disorders associated with chronic alcohol and other drug (AoD) use. 6 • Treatment is essential to stem the economic and human costs associated AoD dependence or addiction. Treatment frequency and intensity of engagement is important for successful outcomes. 3,7 HEdIs Measure definition This measure asses the percentage of adolescent and adults with a new episode of AoD dependence who received the following care. • Initiation of AOD Treatment. The percentage of people who initiated treatment through an inpatient AoD admission, outpatient visit, intensive outpatient encounter or partial hospitalization within 14 days of the diagnosis. • Engagement of AOD Treatment. The percentage of people with a diagnosis of AoD use or dependence who initiated treatment and had two or more additional services within 30 days of the initiation visit.
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128 N AT I o N A l C o M M I T T E
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130 APPENDIx 1: HEDIS EffECTIVENESS
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134 APPENDIx 2: HEDIS EffECTIVENESS
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142 APPENDIx 4b: ACCREDITED VS. NoN
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148 APPENDIx 6A: ACCREDITED VS. NoN
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150 APPENDIx 6b: ACCREDITED VS. NoN
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152 APPENDIx 7A: PUblICly REPoRTING
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158 APPENDIx 8: PUblICly REPoRTING
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172 MEASURE N AT I o N A l C o M M
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182 APPENDIx 16b: VARIATIoN IN PlAN
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184 REfERENCES N AT I o N A l C o M
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ACkNoWlEDGMENTS Health Plans The 20
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Continuous Improvement and the Expansion of Quality ... - NCQA

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