Adherence to Antipsychotic Medications for Individuals with Schizophrenia (SAA)
What is the SAA — HEDIS® Measure?
Based on current HEDIS recommendations for best practices, members ages 18 years and older during the measurement year with schizophrenia or schizoaffective disorder who were dispensed and remained on an antipsychotic medication for at least 80 percent of their treatment period.
The following will meet compliance:
- The number of members who achieved a proportion of days covered (PDC) of at least 80 percent for their antipsychotic medications during the measurement year. PDC is 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.
NCQA HEDIS Population Definition for This Measure:
Population
- Members who are ages 18 or older as of January 1 of the measurement year with a diagnosis of either schizophrenia or schizoaffective disorder.
- Members with either one acute inpatient encounter or two outpatient visits on different dates of services with a diagnosis of schizophrenia or schizoaffective disorder and at least two antipsychotic medication dispensing events.
Line of Business: Commercial, Medicaid, Medicare
SAA Oral Antipsychotic Medications
- Amitriptyline-perphenazine
- Aripiprazole
- Asenapine
- Brexpiprazole
- Cariprazine
- Chlorpromazine
- Clozapine
- Fluphenazine
- Haloperidol
- Iloperidone
- Loxapine
- Lumateperone
- Lurasidone
- Molindone
- Olanzapine
- Paliperidone
- Perphenazine
- Prochlorperazine
- Quetiapine
- Risperidone
- Thioridazine
- Thiothixene
- Trifluoperazine
- Ziprasidone
| Long-acting injections 14 days supply | Risperidone (excluding Perseris®) |
| Long-acting injections 28 days supply |
|
| Long-acting injections 30 days supply | Risperidone (Perseris®) |
Reference: Adherence to Antipsychotic Medications for Individuals with Schizophrenia (SAA), NCQA HEDIS Tech Specifications
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 a schedule follow-up appointments before the patient leaves appointment.
- Reach out to patients that do not keep follow-up appointments and set flags if available in electronic health records or develop a 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.
To learn more about your practice's current HEDIS performance, 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 Provider Tips for Optimizing HEDIS Results Booklet.