Quality Measures Proposed for
Medicaid Eligible Adults by HHS
The Patient Protection and Affordable Care Act of 2010 (PPACA) has the healthcare industry facing many new initiatives which affect how business is conducted. A current initiative is the development of quality measures for Medicaid eligible adults. By 2012, the PPACA will require the U.S. Department of Health and Human Services (HHS) to publish a final set of these quality measures. Currently there are 51 proposed quality measures, 11 of which affect behavioral health. These proposed quality measures will have an impact on how we are all measured. The 11 proposed behavioral health quality measures are as follows.
Prevention and Health Promotion
1. Alcohol misuse screening, brief intervention and referral for treatment
2. Screening for clinical depression and follow-up planning
Management of Acute Conditions
3. Follow-up after hospitalization for mental illness
Management of Chronic Conditions
4. Antidepressant medication management
5. Annual weight and blood sugar and lipid level assessments for people with bipolar disorder 1 and 2
6. Proportion of patients with bipolar 1 disorder treated with mood stabilizers
7. Annual weight and blood sugar and lipid level assessments for people with schizophrenia
8. Proportion of patients with schizophrenia treated with long-term utilization of antipsychotic medications
9. Proportion of patients with schizophrenia using multiple antipsychotic medications
Availability
10. Initiation and Engagement of alcohol and other drug dependence treatment
11. Mental health utilization
As these quality metrics are finalized and become standard, Genoa Healthcare can help your agency achieve goals against these metrics. Your Genoa Healthcare Pharmacist is an integrated part of your healthcare team and can assist with the follow-up monitoring of clients, provide education and support, help manage side effects, provide medication adherence data for clients, and provide convenient adherence packaging which may improve a clients’ self-management of their depression. Genoa’s clinical laboratory could also work with your agency to develop a program to monitor annual weight, blood sugar, and lipid levels for clients.
HHS is not only required to publish the final core set of quality measures by January 2012, but they must establish a Medicaid Quality Measurement Program to fund the development, testing, and validation of evidence-based measures. Stay tuned to future “Pharmacy Connection” issues for updates on the finalized set of quality measures, including the ways Genoa Healthcare can help you achieve these goals.
For more information regarding the proposed quality measures, see the entire listing online at www.gpo.gov/fdsys/pkg/FR-2010-12-30/pdf/2010-32978.pdf
