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

HEDIS MEASURE

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

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.