The measure assesses adults and adolescents 13 years of age and older with a new episode of alcohol or other drug (AOD) dependence who received the following:
- Initiation of AOD Treatment: Adolescents and adults who initiated treatment through an inpatient AOD admission, outpatient visit, intensive outpatient encounter or partial hospitalization, telehealth or medication-assisted treatment (MAT) within 14 days of diagnosis.
- Engagement of AOD Treatment: Adolescents and adults who initiated treatment and had two or more additional AOD services or MAT within 34 days of the initiation visit.
Treating patients with AOD dependence in the primary care setting is an increasing concern. The early recognition of patients with AOD issues and timely referral to behavioral health services promotes the most effective treatment. Substance dependence may be one of the most preventable health conditions.
Treating patients with AOD dependence in the primary care setting is an increasing concern. The early recognition of patients with AOD issues and timely referral to behavioral health services promotes the most effective treatment. Substance dependence may be one of the most preventable health conditions. Treatment, including MAT, in conjunction with counseling or other behavioral therapies has shown to reduce AOD-associated morbidity and mortality, improve health, productivity and social outcomes and reduce health care spending. Despite strong evidence, less than 20% of individuals with substance use disorders receive treatment (NCQA.org). According to the National Institute on Drug Abuse (NIDA), costs related to crime, lost work productivity and health care due to AOD dependence totaled more than $740 billion annually.
|
Initiation & Engagement of AOD TX |
WHA MY 2019 | WHA MY 2020 | WHA MY 2021 | WHA NCQA Percentile Rank | NCQA 2021 90th Percentile Rank Goal |
|---|---|---|---|---|---|
|
Initiation |
24.80 |
24.09% |
26.44 |
5th |
42.25 |
|
Engagement |
3.88 |
5.34% |
4.66 |
<5th |
16.18 |
|
Exchange - INITIATION & ENGAGEMENT OF aod TX |
WHA MY2019 |
WHA MY2020 |
WHA MY2021 |
WHA NCQA Percentile Rank 2019 |
NCQA my2021 90th Percentile Rank Goal |
|
Initiation |
25.95 |
20.0 |
27.64 |
N/A |
N/A |
|
Engagement |
3.08 |
2.76 |
5.53 |
N/A |
N/A |
|
*Medicare Advantage - INITIATION & ENGAGEMENT OF aod TX |
WHA MY2019 |
WHA MY2020 |
WHA MY2021 |
WHA NCQA Percentile Rank 2019 |
NCQA my2021 90th Percentile Rank Goal |
|
Initiation |
|
|
14.29 |
N/A |
N/A |
|
Engagement |
|
|
0.00 |
N/A |
N/A |
| *First year reporting Medicare Advantage |
The early recognition of patients with AOD issues and timely referral to behavioral health services is a key to the most effective treatment. When you identify a patient for AOD treatment, rather than advising them to call the number on the back of their ID card, make a referral on your patient’s behalf. Magellan/HAI-CA BH professionals are available 24 hours a day 7 days a week at (800) 424-1778. Follow the phone menu prompts to speak directly to a clinician, or suggest the patient make the call before they leave the exam room.
Resources:
9 facts about addiction people usually get wrong. Partnership to End Addiction. (2020, June 17). Retrieved September 8, 2022, from https://drugfree.org/article/9-facts-about-addiction-people-usually-get-wrong
Jennifer Nelson, F. E. (2022, September 6). How to identify and treat patients with substance use disorders. Medscape. Retrieved September 8, 2022, from https://www.medscape.com/viewarticle/980273
O'Neill, A. (2020, December 22). Initiation and engagement of alcohol and other drug abuse or dependence treatment. NCQA. Retrieved September 8, 2022, from https://www.ncqa.org/hedis/measures/initiation-and-engagement-of-alcohol-and-other-drug-abuse-or-dependence-treatment