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Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17


DOMAIN: Behavioral Health

Follow-up care after hospitalization for mental illness or intentional self-harm helps improve health outcomes and prevent readmissions. Recommended post-discharge treatment includes a visit with a mental health provider within 30 days after discharge. Ideally, patients should see a mental health provider within 7 days after discharge.

Explore the percentage of discharges for children and adolescents ages 6 to 17 in each state who were hospitalized for treatment of selected mental illness or intentional self-harm diagnoses and had a follow-up visit with a mental health provider within 7 days after discharge and within 30 days after discharge. 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 discharges among children ages 6 to 17 who were hospitalized for treatment of selected mental illness or intentional self-harm diagnoses and who had a follow-up visit with a mental health provider within (1) 7 days and (2) 30 days after discharge.

Follow-up visits include:

  • Outpatient visits with a mental health provider
  • Intensive outpatient encounters with a mental health provider
  • Partial hospitalizations with a mental health provider
  • Community mental health center visits with a mental health provider
  • Electroconvulsive therapy with a mental health provider
  • Telehealth visits with a mental health provider
  • Observation visits with a mental health provider
  • Transitional care management services with a mental health provider

States voluntarily report on Follow-Up After Hospitalization for Mental Illness: Ages 6 to 17 (FUH-CH) as part of the Core Set of Children's Health Care Quality Measures. These data show performance rates for states that voluntarily reported the measure using Child Core Set measure specifications.

 The included populations for Child Core Set measures can vary by state. For example, some states report a single combined rate for both the Medicaid and CHIP populations, but other states report separate rates for these populations. 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 Child Core Set 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 Hospitalization for Mental Illness: Ages 6 to 17 (FUH-CH) measure, visit Child Health Care Quality Measures.

Notes:

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 for this measure: CO, DE, ID, MT, PR and UT.

The following states reported the measure to CMS, but did not use Child Core Set specifications to calculate the measure: NY and OR. CMS did not include the rates for these states.

The Child 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 Child Core Set specifications, based on National Committee for Quality Assurance (NCQA) 2020 specifications.
  • 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 2019 to December 2019. AZ reported data for FFY 2019.  

DS = Data suppressed because data cannot be displayed per the Centers for Medicare & Medicaid Services’ cell-size suppression policy, which prohibits the direct reporting of data for beneficiary and record counts of 1 to 10 and values from which users can derive values of 1 to 10.

ACO = Accountable Care Organization; ADHD = Attention-Deficit/Hyperactivity Disorder; CCO = Coordinated Care Organization; CHIP = Children’s Health Insurance Program; CMS = Centers for Medicare & Medicaid Services; CPT = Current Procedural Terminology; CY = Calendar Year; ED = Emergency Department; EPSDT = Early and Periodic Screening, Diagnostic, and Treatment; 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.