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.

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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