We use the Healthcare Effectiveness Data and Information Set (HEDIS) standardized performance measures. These measurements evaluate and enhance the quality of mental health and substance abuse care our members receive. More than 90 percent of health plans use HEDIS to measure performance on important aspects of care and service.
We appreciate the quality of care our network providers give to our members. Please encourage members to receive follow-up care within these HEDIS timeframes.
Continuation Phase – Patient should have at least 180 days of prescription medication dispensed out of the 231 days following initiation of medication management.
To assist with compliance, emphasize the need for long-term medication adherence to the member.
The need for washout periods while changing medication is accounted for in the timeframes provided. For example, during the acute phase a provider may use 20 days for washout periods, leaving 10 days in which the member may fail to renew a prescription without compromising compliance.