Behavioral Health Quality Metrics

Review Healthcare Effectiveness Data and Information Set (HEDIS), National Quality Forum (NQF) endorsed, and Centers for Medicare & Medicaid Services (CMS) Star Ratings measures for schizophrenia all in one easy-to-use tool. 

A number of quality metrics focused on behavioral health care have been developed by various national organizations. The measures created by these health care quality entities focus on different aspects of population health management and vary in scope from process-related to clinically-focused metrics, as well as medication adherence and other aspects of health care quality measurement.* 

*This tool provides summaries from three, nationally-recognized, quality entities. Note: Other quality organizations may offer additional measures for individuals with schizophrenia. 

Select a health care quality entity to expand and read more.

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About National Committee for Quality Measures (NCQA) HEDIS Measures1
HEDIS Measure for Follow-up After Hospitalization for Mental Illness1,2
HEDIS Measure for Diabetes Screening for People With Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications1,2
HEDIS Measure for Diabetes Monitoring for People with Diabetes and Schizophrenia1,2
HEDIS Measure for Cardiovascular Monitoring for People With Cardiovascular Disease and Schizophrenia1,2
HEDIS Measure for Adherence to Antipsychotic Medications for Individuals with Schizophrenia1,2
About NQF-Endorsed Measures3
NQF1879: Adherence to Antipsychotic Medications for Individuals with Schizophrenia4
NQF1927: Cardiovascular Health Screening for People with Schizophrenia or Bipolar Disorder Who Are Prescribed Antipsychotic Medications4
NQF1932: Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications4
NQF1933: Cardiovascular Monitoring for People with Cardiovascular Disease and Schizophrenia4
NQF1934: Diabetes Monitoring for People with Diabetes and Schizophrenia4
NQF1937: Follow-Up After Hospitalization for Schizophrenia (7- and 30-day)4
About CMS Star Ratings Measures3
C05 — Improving or Maintaining Mental Health3
C21 — Plan All-Cause Readmissions3
C22—Getting Needed Care5
C32—Plan Makes Timely Decisions About Appeals5
D09—Getting Needed Prescription Drugs5

References
  1. National Committee for Quality Assurance. HEDIS® & Performance Measurement—Measuring Performance. www.ncqa.org/tabid/59/Default.aspx. Accessed on May 31, 2022.
  2. National Committee for Quality Assurance. 2017 State of Health Care Quality—HEDIS Measures of Care. www.ncqa.org/report-cards/health-plans/state-of-health-care-quality/2017-table-of-contents. Accessed on May 31, 2022.
  3. National Quality Forum. NQF’s History. www.qualityforum.org/about_nqf/history. Accessed on May 31, 2022.
  4. National Quality Forum. NQF-Endorsed Measures. www.qualityforum.org/QPS/QPSTool.aspx. Accessed on May 31, 2022.
  5. Centers for Medicare & Medicaid Services. Medicare 2016 2018 Part C & D Star Ratings Technical Notes. www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenin/PerformanceData.html.