Neighborhood Health Plan of Rhode Island (Neighborhood) requests your help in improving the quality metrics for the HEDIS measure: Initiation and Engagement of Alcohol and Other Drug Dependence Treatment.
How is IET Measured?
The IET measure has two separate components. It is based on all members 13 years of age and older with a new episode of alcohol or other drug abuse or dependence.
Initiation of Treatment: The percentage of members 13 years of age and older with a diagnose of alcohol and other drug (AOD) dependence who initiate treatment through an inpatient AOD admission, outpatient visit, intensive outpatient encounter or partial hospitalization, telehealth or medication assisted treatment (MAT) within 14 days of the diagnosis.
Engagement in Treatment: The percentage of members 13 years of age and older with a diagnose of alcohol and other drug dependence who initiated treatment and who had two or more additional AOD services or medication assisted treatment (MAT) within 34 days of the initiation visit.
What is Neighborhood’s Performance?
Neighborhood’s Medicaid HEDIS Rate for 2018 is 42.65% for initiation and 18.55% for engagement. Both of these rates are well below the National Medicaid Quality Compass 90th percentiles. Neighborhood’s rate for the INTEGRITY-MMP population for initiation is 42.01% and 13.29% for engagement. These rates are also below the quality benchmarks for these measures.
How You Can Help
For your patients newly diagnosed with Substance Use Disorder (SUD), it is important to begin treatment with a substance abuse provider within 14 days of their diagnosis and have two additional visits within 34 days after their first visit.
How Neighborhood Can Help
Neighborhood’s Behavioral Health partner, Optum, has specific resources available to all physicians that will help you identify SUD treatment providers and schedule appointments for your patients.
- Provide 24/7 support for providers and patients – Substance Use Disorder Helpline: 1-855-780-5955
- 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 license clinician or by going on line and search liveandworkwell.com
- Screening tools are available on providerexpress.com > Clinical Resources > Alcohol or Other Drug Disorders.
- You can also find additional tools and information about behavioral health issues on providerexpress.com > Clinical Resources > Behavioral Health Toolkit for Medical Providers.
- Patient education information is available on liveandworkwell.com using access code “clinician.” See “Mind & Body” at the top, scroll down to find the links to specific topics.