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Metabolic Monitoring for Children and Adolescents on Antipsychotics

April 2021

Neighborhood requests your help in improving our performance on the HEDIS quality measure Metabolic Monitoring for Children and Adolescents on Antipsychotic medications.

How is Metabolic Monitoring for Children and Adolescents on Antipsychotic (APM) Measured?

The APM is measured as the percentage of children and adolescents 1–17 years of age who had two or more antipsychotic prescriptions during the measurement year and had metabolic testing. The measure is stratified into two components based on whether the metabolic test was for blood glucose or for cholesterol, and reported in three age groups. The three age group breakdowns are 1-11 years, 12-17years, and total population ages 1-17 years.

What is Happening Nationally?

According to an article published by the US National Library of Medicine National Institutes of Health by Joyce Nolan Harrison et al., “Approximately 14% to 20% of children and adolescents have a diagnosable mental illness, with an annual cost that is estimated to be $247 billion.” The cost increases when one factors in the increased risk of weight gain, drowsiness, and diabetes while taking the antipsychotic medications. This article also noted that “Low-income children, who are already at greater risk for mental health problems and obesity, may be particularly vulnerable to these metabolic and endocrine abnormalities.”

What is Neighborhood’s Performance?

Neighborhood’s Medicaid HEDIS Rate APM for CY 2019 was 30.44%. This rate is for children ages 1 – 17 years who have had a blood glucose and cholesterol testing. This rate is well below the National Medicaid Quality Compass 90th percentile rate of 56.34%.

How You Can Help?

  • Be sure to order a metabolic test for blood glucose or for cholesterol on an annual basis for your patients using antipsychotic medications.
  • Follow up with your patients and review their lab results annually.
  • Educate the parent or guardian of the child that properly monitoring cholesterol and glucose decreases risks of long-term chronic illnesses.
  • Talk with the parent or guardian about the importance of coordination between primary care and behavioral health care.
  • Continue to encourage patients to take medications as prescribed and report any side effects that they be experiencing.

Resources Available to Help You

Neighborhood’s Behavioral Health partner, Optum, has specific resources available to all providers that will help you identify mental health providers and schedule appointments for your patients.

  • Request coordination of care and referrals for your patients by calling the number on the back of the member’s health plan ID card to speak to a licensed clinician or by searching liveandworkwell.com using access code “clinician.”

You can also find additional tools and information about behavioral health issues on providerexpress.com > Clinical Resources > Clinical Tools and Quality Initiatives.