Unhealthy Alcohol Use Screening and Follow-Up (ASF-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 18 years of age and older who were screened for unhealthy alcohol use using a standardized instrument and, if screened positive, received appropriate follow-up care.

Unhealthy Alcohol Use Screening. The percentage of members who had a systematic screening for unhealthy alcohol use.

Follow-Up Care on Positive Screen. The percentage of members receiving brief counseling or other follow-up care within 2 months of screening positive for unhealthy alcohol use.

Numerator Compliance

Numerator 1—Unhealthy Alcohol Use Screening
Members with a documented result for unhealthy alcohol use screening performed between January 1 and November 1 of the measurement period.

Numerator 2—Follow-Up Care on Positive Screen
Members receiving alcohol counseling or other follow-up care on or up to 60 days after the date of the first positive screen (61 days total).

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

75624-7 Total score [AUDIT]

The total score on the Alcohol Use Disorders Identification Test (AUDIT) ranges from 0 to 40 and reflects the extent of alcohol involvement along a broad continuum of severity. Total scores of 8 or more suggest possible hazardous and harmful alcohol use.(WHO, 2012) Comments from patients about their drinking may provide the interviewer with information that can be valuable in the interpretation of the AUDIT total score.

75626-2 Total score [AUDIT-C]

The Alcohol Use Disorders Identification Test C (AUDIT-C) is scored on a scale of 0-12 where the higher the score, the more likely the patient's drinking is hazardous. A score of 4 or more for men and 3 or more for women is considered positive for hazardous drinking or active alcohol use disorders. If the points are all from Question 1 alone where 2 and 3 are 0, it is likely the patient is drinking below recommended limits. The care provider may review the patients alcohol intake over that past few months to confirm accuracy.

75889-6 How often have you had four or more drinks in one day during the past year [Reported]

A question asked to determine if the patient is considered a ‘risky drinker’. This term was created for, but not limited in use to, an electronic Clinical Quality Measure (eCQM) to be used in the CMS EHR Incentive Program for Meaningful Use. The eCQM allows for multiple ways to screen for alcohol misuse, including AUDIT-C [LOINC:75626-2] or one of two questions that assess whether the patient consumes alcohol [LOINC:75855-7] and the frequency of heavy drinking days (this LOINC). The LOINC for five (5) or more drinks per day is [LOINC:88037-7].

88037-7 How often have you had five or more drinks in one day during the past year [Reported]

Some measures (like electronic Clinical Quality Measure (eCQM) used by CMS) define “risky drinker” differently based on gender: 4 or more drinks per day for women and 5 or more drinks per day for men. The LOINC for 4 or more drinks per day is [LOINC:75889-6].

Z71.41 Alcohol abuse counseling and surveillance of alcoholic