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Follow-Up After Hospitalization for Mental Illness (FUH)

What is the FUH — HEDIS® Measure?

Based on current NCQA HEDIS recommendations for best practices, members ages 6 years and older who were hospitalized for treatment of select mental illness or intentional self-harm diagnoses, should have received a follow-up visit with a mental health provider.

The following will meet compliance when completed during the measurement year:

7-Day Follow-Up:

A follow-up visit with a mental health provider within seven days after discharge

  • Per HEDIS specifications, do not include visits that occur on the date of discharge

30-Day Follow-Up

A follow-up visit with a mental health provider within 30 days after discharge

  • Per HEDIS specifications, do not include visits that occur on the date of discharge

 Best Practices

  • Educate patients and caregivers on the importance of follow-up care to reduce the risk of inpatient admission.
  • Discuss the importance of seeking follow-up care with a mental health provider.
  • Train staff on the “Teach-Back Method” to ensure patients and caregivers review and understand discharge instructions and the next steps in their care for follow-up.
  • Develop outreach systems or assign case managers to encourage recently released patients to keep follow-up appointments or reschedule missed appointments.
  • Reach out to patients who do not keep initial follow-up appointments.
  • Set flags, if available, in EHR or develop a tracking method for patients due or past due for follow-up after discharge visits.
  • Coordinate care with behavioral health practitioners by sharing progress notes and updates.
  • Notify our Concurrent Review team of patient's aftercare information on the day of discharge.

NCQA HEDIS Population Definition for This Measure:

Population: Members ages 6 years and older as of the date of an acute inpatient discharge with a principal diagnosis of mental illness or intentional self-harm on the discharge claim on or between January 1 and December 1 of the measurement year.

Line of Business: Commercial, Medicaid, Medicare

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 Emergency Department Visit for Mental Illness (FUM), NCQA HEDIS 2022 Tech Specifications