PCMH Depression Screening webinar 4/14/21

April 14, 2021

Depression is a leading cause of disability in the U.S. Major depression affects woman at a rate of 2:1 in relation to it affecting men. Woman have a lifetime prevalence of 21% for a major depression episode. 8% of pregnant women experience major depression and depressed mothers may have infants that display delayed psychological, cognitive, neurologic, and motor development. Studies have found that more than half of pregnant and non-pregnant women experience depression that was undiagnosed.

 

Outline

1.  Review the definition of HEDIS Electronic Clinical Data System (ECDS) and the 6 quality measures

  1. List examples of ECDS data sources (e.g., EHRs, files, HIEs, registries, etc.)

2. Include examples of how PH MCOs are using ECDS for the Depression Measure

  1. For each PH MCO:
    1. Which ECDS data sources are you using (HIE, EHR, etc.)?
    2. Getting feeds from providers or vendors?

3. Review the USPSTF recommendation / evidence for depression screening/follow-up

4. Review an example of a depression screening and follow-up workflow using the PHQ-2/PHQ-9

  1. Direct people to resources for clinical workflows

5. Describe the numerators and denominators for the quality measure, "Depression Screening and Follow-Up for Adolescents and Adults" 

6. List and summarize the "standardized instruments" for the adolescent population and the adult population, and define what constitutes as a positive score for each tool (per HEDIS specs)

7. To develop an infrastructure for ECDS, explain why discrete data fields are needed for the ECDS reporting

8. List examples of discrete data fields that would enable ECDS reporting for this measure (e.g., drop down list of validated depressing tool used, the score, the date it was administered, referral (y/n), and the follow-up date)

9. Describe what qualifies as a "follow-up on a positive screen" and how to operationalize the definition of the "follow-up date" under different "follow-up" care scenarios (e.g., clarify that the "follow-up date" is when the patient received the follow-up care and not the date of the referral to follow-up care)

  1. Mention that "follow-up" can include but is not limited to a separate billable BH code/visit
  2. Identify the appropriate codes and not they should be used for HEDIS credit even if they are not being paid
  3. How is "BH diagnoses" defined in the context of Follow-up Service

10. Refer PCMHs to the PCMH Learning Network’s existing presentations, guides, and resources that the Network covered during the summer of 2020 on how to use the billing codes for collaborative care management (e.g., 99492, 99493, and 99494 for non-FQHCs/RHCs or G0512 for FQHCs/RHCs) and general integrated care services (e.g., 99484 for non-FQHCs/RHCs or G0511 for FQHCs/RHCs) T1015 billed to BH MCO for BHC services (SEPA FQHCs billed to BH MCOs)

  1. https://www.tomorrowshealthcare.org/home/communities/pcmh/pcmh-learning-sessions/july-16-2020-virtual-learning-session-western-pa/2965-anna-ratzliff-cocm-workflow-and-billing-2020/file
  2. https://www.tomorrowshealthcare.org/home/communities/pcmh/pcmh-resources/behavioral-health-integration

11. Discuss challenges and experiences

  1. PCMH Question: Where do you currently document depression screening and follow-up?
  2. MCO Question: If the PCMHs document in these discrete data fields, will it be pulled from this place? How will the data validation steps assure it is pulled from the right place?
  3. Suggested action: Talk with your MCOs about this.

Target Audience

Nurse

Physician

Social Worker

Learning Objectives

  • Describe the evidence for depression screening and follow-up
  • Outline workflows for depression screening and follow-up in primary care settings
  • Describe the numerators and denominators for the quality measure, “Depression Screening and Follow-Up for Adolescents and Adults”
  • Describe data fields for the quality measure, “Depression Screening and Follow-Up for Adolescents and Adults”
Course summary
Available credit: 
  • 1.00 AMA PRA Category 1 Credit™
    The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
  • 1.00 ANCC
    UPMC Provider Unit is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation
  • 1.00 ASWB
  • 1.00 Attendance
Course opens: 
04/14/2021
Course expires: 
07/31/2021
Event starts: 
04/14/2021 - 12:00pm
Event ends: 
04/14/2021 - 1:00pm

Outline

1. Review the definition of HEDIS Electronic Clinical Data System (ECDS) and the 6 quality measures

  1. List examples of ECDS data sources (e.g., EHRs, files, HIEs, registries, etc.)

2. Include examples of how PH MCOs are using ECDS for the Depression Measure

  1. For each PH MCO:
    1. Which ECDS data sources are you using (HIE, EHR, etc.)?
    2. Getting feeds from providers or vendors?

3. Review the USPSTF recommendation / evidence for depression screening/follow-up

4. Review an example of a depression screening and follow-up workflow using the PHQ-2/PHQ-9

  1. Direct people to resources for clinical workflows

5. Describe the numerators and denominators for the quality measure, "Depression Screening and Follow-Up for Adolescents and Adults" 

6. List and summarize the "standardized instruments" for the adolescent population and the adult population, and define what constitutes as a positive score for each tool (per HEDIS specs)

7. To develop an infrastructure for ECDS, explain why discrete data fields are needed for the ECDS reporting

8. List examples of discrete data fields that would enable ECDS reporting for this measure (e.g., drop down list of validated depressing tool used, the score, the date it was administered, referral (y/n), and the follow-up date)

9. Describe what qualifies as a "follow-up on a positive screen" and how to operationalize the definition of the "follow-up date" under different "follow-up" care scenarios (e.g., clarify that the "follow-up date" is when the patient received the follow-up care and not the date of the referral to follow-up care)

  1. Mention that "follow-up" can include but is not limited to a separate billable BH code/visit
  2. Identify the appropriate codes and not they should be used for HEDIS credit even if they are not being paid
  3. How is "BH diagnoses" defined in the context of Follow-up Service

10. Refer PCMHs to the PCMH Learning Network’s existing presentations, guides, and resources that the Network covered during the summer of 2020 on how to use the billing codes for collaborative care management (e.g., 99492, 99493, and 99494 for non-FQHCs/RHCs or G0512 for FQHCs/RHCs) and general integrated care services (e.g., 99484 for non-FQHCs/RHCs or G0511 for FQHCs/RHCs) T1015 billed to BH MCO for BHC services (SEPA FQHCs billed to BH MCOs)

  1. https://www.tomorrowshealthcare.org/home/communities/pcmh/pcmh-learning-sessions/july-16-2020-virtual-learning-session-western-pa/2965-anna-ratzliff-cocm-workflow-and-billing-2020/file
  2. https://www.tomorrowshealthcare.org/home/communities/pcmh/pcmh-resources/behavioral-health-integration

11. Discuss challenges and experiences

  1. PCMH Question: Where do you currently document depression screening and follow-up?
  2. MCO Question: If the PCMHs document in these discrete data fields, will it be pulled from this place? How will the data validation steps assure it is pulled from the right place?
  3. Suggested action: Talk with your MCOs about this.
Statewide Webinar
Pittsburgh, PA
United States
  • Robert Ferguson, MPH, Chief Policy Officer, JHF
  • Carol Frazer, LPC, Practice Transformation Specialist, PRHI
  • Suzanne Cohen, MPH, Senior Director of Population Health, The Health Federation of Philadelphia
  • Deb McGrath, Debra McGrath, MSN, FNP, Director of Health Information Technology

In support of improving patient care, this activity has been planned and implemented by the University of Pittsburgh and The Jewish Healthcare Foundation. The University of Pittsburgh is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

As a Jointly Accredited Organization, University of Pittsburgh is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. University of Pittsburgh maintains responsibility for this course. Social workers completing this course receive 1.0 continuing education credits.

Available Credit

  • 1.00 AMA PRA Category 1 Credit™
    The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
  • 1.00 ANCC
    UPMC Provider Unit is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation
  • 1.00 ASWB
  • 1.00 Attendance
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