Depression Remission or Response for Adolescents and Adults (DRR-E)

HEDIS MEASURE

Line of business: Commercial Medicaid Medicare

Data Collection Method

Administrative (Claims)

Supplemental Data Submission

Standard - Electronic Clinical Data System (ECDS) Layout

Measure Description

The percentage of members 12 years of age and older with a diagnosis of depression and an elevated PHQ-9 score, who had evidence of response or remission within 4–8 months of the elevated score.

Follow-Up PHQ-9. The percentage of members who have a follow-up PHQ-9 score documented within 4–8 months after the initial elevated PHQ-9 score.

Depression Remission. The percentage of members who achieved remission within 4–8 months after the initial elevated PHQ-9 score.

Depression Response. The percentage of members who showed response within 4–8 months after the initial elevated PHQ-9 score.

Numerator Compliance

The PHQ-9 assessment does not need to occur during a face-to-face encounter; it may be completed over the telephone or through a web-based portal.

Numerator 1—Depression Follow-Up

A PHQ-9 total score in the member’s record during the depression follow-up period.

Numerator 2—Depression Remission

Members who achieve remission of depression symptoms, as demonstrated by the most recent PHQ-9 score of <5 during the depression follow-up period.

Numerator 3—Depression Response

Members who indicate a response to treatment for depression, as demonstrated by the most recent PHQ-9 total score being at least 50 percent lower than the PHQ-9 score associated with the IESD, documented during the depression follow-up period.

Best Practices

Educate the patient about the importance of follow-up and adherence to treatment recommendations
Discuss the importance of timely, recommended follow-up visits
Schedule follow-up appointments as soon as possible, particularly those patients recently discharged
Coordinate care with behavioral health practitioners by sharing progress notes and updates
Outreach patients who cancel appointments and assist them with rescheduling as soon as possible
Consider telemedicine visit when in-person visits are not available
Discuss the importance of seeking follow-up with a mental health provider
Develop outreach internal team and/or assign care/case managers to members to ensure members keep follow-up appointments or reschedule missed appointments
Set flags if available in EHR or develop tracking method for patients who may need screenings and follow-up visits

Quality Value Set Directory Coding Tips

44261-6 Patient Health Questionnaire 9 item (PHQ-9) total score [Reported]

The PHQ-9 is the standard (and most commonly used) depression measure, and it ranges from 0-27 Scoring: Add up all checked boxes on PHQ-9. For every check: Not at all = 0; Several days = 1; More than half the days = 2; Nearly every day = 3 (the scores are the codes that appear in the answer list for each of the PHQ-9 problem panel terms). Interpretation: 1-4 = Minimal depression; 5-9 = Mild depression; 10- 14 = Moderate depression; 15-19 = Moderately severe depression; 20-27 = Severed depression

89204-2 Patient Health Questionnaire-9: Modified for Teens total score [Reported.PHQ.Teen]

The Patient Health Questionnaire-9: Modified for Teens (PHQ-9 Teen) total score is the sum the first of 9 items (the answers to the other 4 items are used to assess the functional impairment due to depression and screen for dysthymia and suicide risk). These 9 items are scored from 0 to 3, with higher scores indicating more severe symptoms of depression.