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Follow-Up After High-Intensity Care for Substance Use Disorder (FUI)

What is the FUI — HEDIS® Measure?

Based on current NCQA HEDIS recommendations for best practices, the percentage of acute inpatient hospitalizations, residential treatment or detoxification visits for a diagnosis of Substance Use Disorder (SUD) among members 13 years of age and older that result in a follow-up visit or service for SUD.

The following will meet HEDIS compliance:

7-Days After Discharge:

A follow-up visit or event with any practitioner for a principal diagnosis of SUD within the seven days after the visit or discharge.

30-Days After Discharge:

A follow-up visit or event with any practitioner for a principal diagnosis of substance use disorder within the 30 days after the visit or discharge.

Best Practices

  • Discuss the importance of timely, recommended follow-up visits.
  • Use the same diagnosis for SUD at each follow-up.
  • Coordinate care between Behavioral Health and Primary Care Physicians (e.g. share progress notes and updates and include diagnosis for SUD).
  • Reach out to patients who cancel appointments and assist them with rescheduling as soon as possible.
  • Consider telemedicine visits when in-person visits are not available.
  • Notify our Concurrent Review team of patient's aftercare information on the day of discharge.

NCQA HEDIS Population Definition for this Measure

Population: Members who are 13 years of age or older as of the discharge date, stay or event on or between January 1 and December 1 of the measurement year

Line of Business: Commercial, Medicaid, Medicare

Opioid Use Disorder Treatment Medications

  • Naltrexone (oral and injectable)
  • Buprenorphine (sublingual tablet, injection, implant)
  • Buprenorphine/naloxone (sublingual tablet, buccal)

Alcohol Use Disorder Treatment Medications

  • Disulfiram (oral)
  • Naltrexone (oral and injectable)
  • Acamprosate (oral and delayed-release tablet)

To learn more about your practice’s current HEDIS performance, 2022 HEDIS Value sets for this or other measures, or for assistance in compliance with the HEDIS guidelines, please email BH_HEDISTeam@HorizonBlue.com or visit https://www.horizonblue.com/providers/resources/guidelines/hedis-measurement-year-my-2022-provider-tips-optimizing-hedis-results

Reference: Follow-Up After High-Intensity Care for Substance Use Disorder (FUI), NCQA HEDIS 2022 Tech Specifications