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Adherence to Antipsychotic Medications for Individuals With Schizophrenia (SAA)

HEDIS Measure

Adherence to Antipsychotic Medications for Individuals With Schizophrenia (SAA)

Line of business: Commercial Medicaid Medicare

Data Collection Method: Administrative

Measure Description

The percentage of members 18 years of age and older during the measurement year with schizophrenia or schizoaffective disorder who were dispensed and remained on an antipsychotic medication for at least 80% of their treatment period.

Numerator Compliance

Members who achieved a PDC of at least 80% for their antipsychotic medications during the measurement year.

PDC = Proportion of days covered. The number of days a member is covered by at least one antipsychotic medication prescription, divided by the number of days in the treatment period.

Best Practices

  • Educate patients and their caregivers on the importance of medication compliance
  • Discuss with members potential medication side-effects and when to call their provider
  • Ensure providers maintain appointment availability in your practice for patients and schedule follow-up appointments before patient leaves appointment
  • Reach out to patients that do not keep follow-up appointments and set flags if available in EHR or develop tracking method for patients due or past due for follow-up visits and require staff to follow up with patients that miss or cancel their appointment
  • Coordinate care with patients’ behavioral health specialists
  • Outreach patients who cancel appointments and reschedule them as soon as possible

Quality Value Set Directory Coding Tips

Long Acting Injections 14 Days Supply

HCPCS

  • J2794

Long Acting Injections 28 Days Supply

HCPCS

  • J0401
  • J1631
  • J1943
  • J1944
  • J2358
  • J2426
  • J2680

Long Acting Injections 30 Days Supply

HCPCS

  • J2798