NEW PERFORMANCE MEASURES WILL ASSESS SCREENING / TREATMENT OF MATERNAL DEPRESSION
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You get what you measure is an old saying attributed to William Edwards Deming, one of the founding fathers of the quality improvement field.
In other words, if you want to see your priorities,
look at what you measure.
For the FIRST TIME, performance measures for healthcare systems
will include screening and care outcomes for depression
during pregnancy and the postpartum period.
This is a BIG DEAL. Maternal depression
is being measured...so now it's a priority!
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What is the NCQA?
The National Committee for Quality Assurance (NCQA) is a nonprofit organization dedicated to improving healthcare quality. The NCQA administers evidence-based standards, measures, programs, and accreditation. Each year, the NCQA produces a revised set of
HEDIS
®
measures. Learn more about NCQA
HERE
.
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What are HEDIS
®
measures?
The Healthcare Effectiveness Data and Information Set (
HEDIS
®) is a set of 90+ performance measures widely used in the healthcare industry. Over 90% of health plans in the United States (with over 190 million people enrolled) utilize
HEDIS
®. Measures are added, deleted, and revised annually. View the entire list of
HEDIS
® measures
HERE.
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How are HEDIS
®
measures used?
The premise behind HEDIS
®
is simple: HEDIS
®
rewards preventive care. By focusing on prevention, the number of overall doctor visits drops and patients experience better outcomes.
HEDIS
®
ensures that preventive measures -- such as immunizations, cancer screenings, flu shots, and behavioral health assessments -- are routinely provided. Thus HEDIS
®
is a powerful tool in determining
how
and
when
healthcare is delivered.
HEDIS
®
also reflects the clinical quality performance of healthcare plans by determining which healthcare services are performed and showing if those services are improving health conditions.
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PROVIDERS
use HEDIS
®
to ensure timely and appropriate care for patients
HEALTH PLANS
use HEDIS
®
to identify gaps in care and opportunities for improvement
CONSUMERS
use HEDIS
®
to compare health plans "apples to apples"
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What are the NEW measures for maternal depression?
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- Prenatal Depression Screening and Follow-Up measure assesses whether women are screened during the prenatal period and whether follow-up steps, including referral and care, is provided for women who screened positive.
- Postpartum Depression Screening and Follow-Up measure assesses whether women are screened during the postpartum period and whether follow-up steps occurred for women who screened positive.
- Both measures assess whether depression screening was conducted using a standardized tool and can be applied to a variety of healthcare providers including obstetric providers, pediatricians, and family physicians.
- These measures -- while a GIANT step forward -- do not address anxiety or other mental health issues.
- Although these new measures do not specify when women should be screened, ACOG and Bright Futures guidelines suggest women should be screened at least twice during pregnancy, at the postpartum obstetric visit, and at least 4 times during baby's first 6 months.
What are the practical implications of these NEW measures?
- They should be an incentive for providers to screen and treat women for depression during pregnancy and in the postpartum period.
- They will provide insight into clinical care as they draw from electronic medical records and administrative data rather than claims.
- They will be tested in 2020 and revised as necessary.
Read more about these NEW measures
HERE.
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What is performance measurement?
Why is it important in healthcare?
Simply put, performance measurement is a process of setting goals and regularly checking progress toward meeting those goals. Data is collected, analyzed, and reported to show how processes are working. This information is then used to drive decisions. Organizations use a cycle of planning, doing, checking, and acting to continuously improve processes and performance.
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Design or revise business process components to improve results
Implement the plan and measure its performance
Assess the measurements and report the results to decision makers
Decide on changes needed to improve the process
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Using performance measures helps an organization understand, manage, and improve what it does. Performance measures are critical to improving quality, enhancing transparency, and ensuring accountability -- ultimately helping the organization to see how well it is providing care and support.
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Who helped NCQA create these performance measures?
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The
Zoma Foundation
is a Denver-based foundation created by Ben and Lucy Ana Walton in 2016. Early childhood development is a focus area of the Foundation which is committed to reducing social-emotional and cognitive disparities in children from pregnancy through age 5. The Foundation addresses four areas of support for families toward this goal: Mental health for parents, infants and toddlers;
parent and family awareness of early childhood development;
child maltreatment prevention and care; and catalytic tools and initiatives.
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The
California Health Care Foundation
works to ensure that all low-income Californians can get the care they need, when and where they need it, and at a price they can afford. CHCF is especially focused on strengthening Medi-Cal, which covers 1 in 3 Californians and is the cornerstone of California’s safety net. CHCF is currently funding projects to better understand maternal mental health care and to explore ways that it can be improved. CHCF’s maternal mental health work is part of a CHCF-wide focus on behavioral health.
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Working with Policy Makers to Address Maternal Mental Health Challenges
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MMHLA -- founded in 2018 -- is a nonpartisan 501(c)3 non-profit organization
dedicated to promoting the mental health of childbearing women in the United States
by advocating for universal education, screening, referral, and treatment
of postpartum depression and related maternal mental health (MMH) challenges.
Our vision is that all childbearing women in the United States will be educated about and screened for maternal mental health challenges and have access to resources for recovery.
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