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. 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.
COMMERICAL - INITIATION & ENGAGEMENT OF AOD TX
|
WHA MY2021
|
WHA MY2022
|
WHA MY2023
|
WHA NCQA
PERCENTILE RANK |
NCQA MY2023
90TH |
---|---|---|---|---|---|
Initiation
|
26.44
|
24.55
|
29.31
|
10th
|
44.11
|
Engagement
|
4.66
|
5.36
|
9.13
|
10th
|
18.29
|
EXCHANGE - INITIATION &
ENGAGEMENT OF AOD TX |
WHA MY2021
|
WHA MY2022
|
WHA MY2023
|
WHA NCQA
PERCENTILE |
NCQA MY2021
|
---|---|---|---|---|---|
Initiation
|
27.64
|
19.75
|
22.44
|
<5th
|
34.1
|
Engagement
|
5.53
|
5.53
|
6.41
|
<5th
|
34.1
|
*MEDICARE ADVANTAGE -
INITIATION & ENGAGEMENT OF AOD TX |
WHA MY2021
|
WHA MY2022
|
WHA MY2023
|
WHA NCQA
PERCENTILE RANK |
NCQA MY2021
90TH% |
---|---|---|---|---|---|
Initiation
|
14.29
|
18.18
|
16.22
|
N/A
|
N/A
|
Engagement
|
0.00
|
1.82
|
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.
Free opioid and substance use disorder CME: Courses to Satisfy the DEA's 8-Hour Training Requirement: https://www.pri-med.com/state/dea-cme-requirements?refurl=www.google.com
Cleveland Clinic. (SUD). (October 18, 2024). What Is Substance Use Disorder? Retrieved November 4, 2024, from https://my.clevelandclinic.org/health/diseases/16652-drug-addiction-substance-use-disorder-sud
Kumar, Jaya, et al. “Editorial: Substance Use Disorder: Above and beyond Addiction.” Frontiers, Frontiers, 7 May 2024, www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2024.1426351/full
Centers for Disease Control and Prevention. (2024, June 27). Treatment for opioid use disorder: Population Estimates - United States, 2022. Centers for Disease Control and Prevention. https://www.cdc.gov/mmwr/volumes/73/wr/mm7325a1.htm?utm_source=www.thecensus.io&utm_medium=referral&utm_campaign=openai-s-ceo-builds-a-behavioral-health-coach
Last review date: December 5, 2024