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HEDIS Hints: FUM and FUA

  • Follow-Up After Emergency Department Visit for Mental Illness (FUM)
  • Follow-Up After Emergency Department Visit for Alcohol and Other Drug Dependence (FUA)

What are the Measures?

These 2 measures assess the percentage of ED visits for which the patient received a follow-up appointment within 7 days and 30 days of being seen in the ED for mental illness (FUM) and alcohol and other drug dependence (FUA).

The follow-up visit after the ED visit can be with any practitioner. Telehealth can be used as a source of follow up.

FUM: The percentage of emergency department (ED) visits for members 6 years of age and older with a principal diagnosis of mental illness, who had a follow-up visit for mental illness who had a follow up visit for AOD within 7 days and 30 days of being seen in the ED.

FUA: The percentage of emergency department (ED) visits for members 13 years of age and older with a principal diagnosis of alcohol or other drug (AOD) dependence, who had a follow up visit for AOD within 7 days and 30 days of being seen in the ED.

Why are these measures important?

Research shows that people with mental health conditions have more ED reoccurring visits in comparison to those with physical ailments. In addition, young patients seen in the ED with undiagnosed mental illness were likely to have progressed to a point of suicidal intent. Young patients are less likely to get reliable care upon discharge. HEDIS measures are used across the country to measure population health outcomes. These measures help support efforts to improve behavioral health, alcohol and other drug dependence issues.

How can I improve my HEDIS scores?

  • Use appropriate documentation and correct coding.
  • Teach the patient the need for follow up appointments to empower shared decision-making between the provider and the patient.
  • Work collaboratively with hospital ER’s to obtain data exchange reports on your patients seen in the ER for better care coordination.
  • Maintain appointment availability for patients with recent ED visits.
  • Outreach to patients that cancel appointments and reschedule as soon as possible.
  • Collaborate with health plan case management on assisting with social determinants.
     

Reference: National committee for Quality Assurance. (2018). HEDIS 2019 Volume 2 Technical Specifications For Health Plans Washington, DC 20005: American Medical Association. Pg. 202-208.