Medical Director, Suffolk Care Collaborative

March, 2017
Issue 1
Clinical Alert: March 2017

On an as needed basis we will use a "CLINICAL ALERT" to bring to your attention critically important measures or issues.  The HEDIS measures highlighted in this alert are not specific to the DSRIP program and they may be measures that you are also held accountable for through quality programs with payers.  In the DSRIP program Measurement Years for performance start on July 1 and end June 30.  We have just 4 months left to make an impact on measures that were missed in the prior two measurement years.
We are currently in DSRIP Measurement Year 3 (MY3), which encompasses the period of July 1, 2016, through June 30, 2017.  We would ask your assistance in ensuring that within your practice the following measures are met for all eligible patients as applicable for this measurement year.
HEDIS Measure

Children Prescribed ADHD Medications
Three (3) follow-up visits for  patients 6-12 years old who receive a prescription for ADHD medication as a new diagnosis or history of prior medication administration but without any dispensed for a period of 120 days or more:
  • 1 visit within 30 days of medication being dispensed with a practitioner with prescribing authority    
  • 2 follow-up visits within 9 months of the initial visit with a practitioner with prescribing authority

Child RoutinePreventive Care
Children 12 months - 19 years need an ambulatory or preventive care primary care visit during the measurement year

Initiation and Engagementin Treatment of Alcohol/Drug Dependence
Patients 13 and older with a new episode of alcohol or other drug dependence
  • Initial visit within 14 days of identification
  • 2 or more additional services within 30 days of the initial visit
Follow-up after Behavioral Health Hospitalization
Patients age 6 and older who were hospitalized for select mental health disorders were seen by a mental health provider within 7 days of discharge.  Reference SCC Clinical Documentation Improvement (CDI) Program for the specific associated ICD-10 codes. 

HEDIS Measurements for Patients  ages 18 to 64 years:
Glucose or HbA1c - Test completed during measurement year
With schizophrenia and diabetes
HbA1c and LDL-C - Tests completed during measurement year
With schizophrenia and cardiovascular disease
LDL-C - Test completed during measurement year

Thank you for your continued efforts and collaboration on behalf of your patients.  Please let me know if you or your staff need further information or assistance.  We at the Suffolk Care Collaborative are here to assist and support your efforts.
For questions please contact:
Dr. Linda S. Efferen, MD, MBA
Medical Director