HEDIS Depression Measures for Electronic Clinical Data

Why Focus on Depression?

Depression affects both mental and physical health, and is the second leading cause of disability worldwide. Collecting patient-reported outcome measures through typical HEDIS® reporting methods is a challenge, but NCQA sees this as an opportunity to revolutionize how data are collected and reported.

Opportunities for Collaboration

NCQA is leading two initiatives focused on depression care:

Perinatal Depression Quality Measures Field-Test (funded by the California Health Care Foundation and the Colorado-based Zoma Foundation). 
NCQA will use its multi-stakeholder process to specify and test existing HEDIS depression care quality measures for prenatal/postpartum women.

Click here for additional information. 

National Collaborative for Innovation in Quality Measurement (NCINQ) (funded by AHRQ/CMS under the Pediatric Quality Measures Program).
NCINQ is leading a learning collaborative focused on improving performance on depression care measures for adolescents.

Click here for additional information.

Interested plans and providers can participate in one or both projects. Contact Cindy Manaoat (manaoat@ncqa.org) to learn more these projects.

What are the Depression Care measures?

NCQA adapted existing provider- and practice-level quality measures to include in HEDIS reporting, using data from electronic clinical data systems (ECDS):

Depression Screening and Follow-Up for Adolescents and Adults (DSF)
Adapted from a provider-level measure developed by Quality Insights of Pennsylvania (QIP) (NQF #0418, CMS2), first implemented in HEDIS 2018.

The percentage of members 12 years of age and older who were screened for clinical depression using a standardized tool and, if screened positive, who received follow-up care.

  • Denominator: All members ≥12 years of age.
  • Numerator: Screened for depression using a standardized tool and, if screened positive, received follow-up care within 30 days.

Utilization of the PHQ-9 to Monitor Depression Symptoms for Adolescents and Adults (DMS)
Adapted from a depression measure developed by Minnesota Community Measurement(NQF #0712), first implemented in HEDIS 2016.

The percentage of members 12 years of age and older with a diagnosis of depression, who had an outpatient encounter with a PHQ-9 score present in their record in the same assessment period as the encounter.

  • Denominator: All members ≥12 years of age who had an encounter during a 4-month period with a diagnosis of major depressive disorder or dysthymia.
  • Numerator: Documented results of a PHQ-9 tool that was administered at least once during the 4-month period.

Depression Remission or Response for Adolescents and Adults (DRR)
Adapted from depression measures developed by Minnesota Community Measurement (NQF #0711 and #1884), first implemented in HEDIS 2017.

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 after the initial elevated PHQ-9 score.

  • Denominator: All members ≥12 years of age with a diagnosis of major depressive disorder or dysthymia who had an initial elevated PHQ-9 score of >9.
  • Numerator: A follow-up PHQ-9 score documented at 4–8 months after the initial elevated score; a PHQ-9 score <5 documented at 4–8 months following the initial elevated score; a ≥50% reduction in the PHQ-9 score documented at 4–8 months following the initial elevated score.

How can I access the Depression Care measures?

Find these measures in HEDIS Volume 2: Technical Specifications, or click here.

Measure packages include the ECDS guidelines, HEDIS measure descriptions and logic calculations.

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

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