HEDIS® Tip Sheet

Follow-Up After Hospitalization for Mental Illness (FUH)

Line of business: BlueAlliance (Commercial) & BlueAlliance Care+ (Medicaid)

Measure Description

Percentage of members 6 years of age and older who were discharged after hospitalization for treatment of selected mental illness or intentional self-harm diagnoses and who had a follow-up visit with a mental health provider. 

Two rates reported for this measure:

  • Percentage of discharges for members who received follow-up within 30 days of discharge.
  • Percentage of discharges for members who received follow-up within 7 days of discharge.
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Compliance for 7-Day and 30-Day Follow-Up

A follow-up service with a mental health provider or with a diagnosis of mental health disorder in the following settings after discharge.

  • Outpatient visit.
  • An intensive outpatient visit or partial hospitalization.
  • A community mental health center visit.
  • Electroconvulsive therapy.
  • Telehealth visit.
  • Transitional care management services.
  • A visit in a behavioral healthcare setting.
  • Telephone visit.
  • Psychiatric collaborative care management.
  • Peer support services.
  • Psychiatric residential treatment.
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Notes

  • The denominator is based on acute inpatient discharges for a principal diagnosis of mental illness or intentional self-harm.
  • Follow up visits that occur on the same day as discharge do not count toward measure compliance.
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Exclusions

  • Readmissions/direct transfers to a nonacute inpatient care setting within the 30-day follow-up period regardless of the primary diagnosis for readmissions.
  • Members in hospice during the measurement year.
  • Members who died during the measurement year. 
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Best Practices

  • Utilize EMR and reports to assist in tracking patients in need of follow-up visits so appropriate outreach and referrals can be made.
  • Schedule follow up visits as soon as possible and educate patients, utilizing teach back methods, on the importance of keeping follow-up appointments.
  • Include caregivers, if applicable, in understanding discharge and follow-up instructions.
  • Develop systems for outreach, such as case managers, to encourage follow-up appointments or assist with re-scheduling missed appointments.
  • Assist patients to connect with behavioral health practitioners.
  • Educate patients on the importance of follow-up and adhering to treatment recommendations.
  • Refer patients to community resources for support when appropriate.

Coding Disclaimer

The analysis of any medical coding question related to a measure is dependent on the measure’s technical specifications including the factual situations present related to the member, the practice, the professionals, and the medical services provided.

Questions  

Should you have questions related to coding, mental health provider criteria, etc., please contact BlueAlliance@bcbsnd.com.

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