Product Lines:
Advantage MD, Dual Eligible Special Needs Plans (D-SNP), EHP, Priority Partners and USFHP.

Eligible Population:
Members 18 years of age and older by December 31 of the measurement year.

Definition:
Measure evaluates percentage of members 18 years of age and older who were treated with antidepressant medication, had a diagnosis of major depression and who remained on an antidepressant medication treatment.

Two rates are reported:

• Effective Acute Phase Treatment: percentage of members who remained on an antidepressant medication for at least 84 days (12 weeks)
• Effective Continuation Phase Treatment: percentage of members who remained on an antidepressant medication for at least 180 days (6 months)

Continuous Enrollment:

• 105 days prior to the IPSD* through 231 days after the IPSD.

*IPSD: Index prescription start date. The earliest prescription dispensing date for an antidepressant medication where the date is in the intake period and there is a Negative medication history.

Best Practice and Measure Tips

The American Psychiatric Association and The Substance Abuse and Mental Health Services Administration recommend patients complete the Patient Health Questionnaire (PHQ)-9 screening tool as needed.  Consider the following if you diagnose the patient with depression and prescribe medication.

• Encourage them to attend psychotherapy.
• Let them know it can take several months for antidepressant medication to be effective.
• Remind them to continue their medication for at least six months.
• Give members written instructions to reinforce teaching about the proper use of medication and what to do if they experience side effects.
• Discuss other factors that may improve symptoms, such as aerobic exercise and counseling or therapy
• Follow up within 30 days from when prescribe medication is filled for any side effects and their response to treatment.
• For patients with complex conditions, consider referring them to a psychiatrist.
• Coordinate Care by sharing progress notes and updates with behavioral health provider.
• For Members who cancel or missed appointments, reach out to them and reschedule as soon as possible.

Measure Exclusions

Required Exclusion:

• Members in hospice or using hospice services anytime during the measurement year. 
• Members who died any time during the measurement year.
• Members who did not have an encounter with a diagnosis of major depression during the 121-day period from 60 days prior to the Index prescription start date (IPSD), through the IPSD and the 60 days after the IPSD. 

Measure Medications

Antidepressant Medications