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Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older

DOMAIN: Behavioral Health

Timely follow-up care after an emergency department (ED) visit for mental illness or intentional self-harm may reduce repeat ED visits, prevent hospital admissions, and improve health outcomes. The period immediately after the ED visit is important for engaging individuals in treatment and establishing continuity of care.

Explore the percentage of ED visits for adults in each state with a principal diagnosis of mental illness or intentional self-harm with a follow-up visit for mental illness within 7 days of the ED visit and within 30 days of the ED visit. Higher rates are better on this measure.

The purple dashed line represents the median, or middle, of all values reported.

This measure reports state performance on the percentage of ED visits for adults age 18 or older with a principal diagnosis of mental illness or intentional self-harm and who had a follow-up visit for mental illness within (1) 7 days and (2) 30 days of the ED visit.

Follow-up visits include:

  • Outpatient visits
  • Intensive outpatient encounters
  • Partial hospitalizations
  • Community mental health center visits
  • Electroconvulsive therapy
  • Telehealth visits
  • Observation visits

States voluntarily report on Follow-up After Emergency Department Visit for Mental Illness (FUM-AD) as part of the Core Set of Adult Health Care Quality Measures. These data show performance rates for states that voluntarily reported the measure using Adult Core Set measure specifications.

The included populations for Adult Core Set measures can vary by state. For example, some states include populations in certain programs, such as beneficiaries covered by Medicaid, but exclude beneficiaries in other programs, such as those dually eligible for Medicare and Medicaid. In addition, states may include beneficiaries in some delivery systems, but exclude other delivery systems. For example, a state may include beneficiaries who are enrolled in managed care, but exclude beneficiaries who are covered on a fee-for-service (FFS) basis. This variation in populations can affect measure performance and comparisons between states.

Specifications for this measure changed substantially for Federal Fiscal Year (FFY) 2019. Rates are not comparable with rates reported for previous years.

Source: Mathematica analysis of Medicaid and CHIP Program System (MACPro) reports for the FFY 2020 reporting cycle as of June 18, 2021; see 2020 Child and Adult Health Care Quality Measures. For more information on the Follow-Up After Emergency Department Visit for Mental Illness (FUM-AD) measure, visit Adult Health Care Quality Measures.


The term “states” includes the 50 states, the District of Columbia, and Puerto Rico. The following states did not report data to the Centers for Medicare & Medicaid Services (CMS) for either the 7-day Follow-Up or 30-day Follow-Up rate: AK, CO, ID, IL, LA, ME, MD, MI, MT, SD, UT, and WY.

The Adult Core Set specifications include guidance for calculating this measure using the administrative method. Unless otherwise specified, the administrative data source is the state’s Medicaid Management Information System (MMIS) and/or data submitted by managed care plans, including behavioral health plans.

Unless otherwise specified:

  • States used Adult Core Set specifications, based on National Committee for Quality Assurance (NCQA) 2020 specifications. The following states used NCQA 2019 specifications: OR.
  • Denominators are assumed to be the measure-eligible population for states using the administrative method. Some states reported exclusions from the denominator, as noted in the state-specific comments.
  • The measurement period for this measure was January 1, 2019 to December 31, 2019. AZ and KY reported data for FFY 2019.
  • Rates displayed reflect state reporting for Medicaid enrollees ages 18 to 64 (39 states), or age 18 and older (1 state).

ACO = Accountable Care Organization; AHRQ = Agency for Healthcare Research and Quality; CCO = Coordinated Care Organization; CHIP = Children’s Health Insurance Program; CMS = Centers for Medicare & Medicaid Services; CMO = Care Management Organization; CY = Calendar Year; ED = Emergency Department; EHR = Electronic Health Record; EQRO = External Quality Review Organization; FFS = Fee for Service; FFY = Federal Fiscal Year; HCBS = Home- and Community-Based Services; HEDIS = Healthcare Effectiveness Data and Information Set; HMO = Health Maintenance Organization; ICD = International Classification of Diseases; LOINC = Logical Observation Identifiers Names and Codes; MACPro = Medicaid and CHIP Program System; MCO = Managed Care Organization; MMIS = Medicaid Management Information System; NCQA = National Committee for Quality Assurance; NR = Not Reported; PCCM = Primary Care Case Management; PCP = Primary Care Practitioner.