First-Line Psychosocial Care for Children and Adolescents on Antipsychotics: Performance Measure Results
The performance measure assessed the use of first-line psychosocial care for children and adolescents on antipsychotics in Virginia, showing a total measure result of 68.98%. The measure aims to promote safer interventions before prescribing antipsychotic medications to minimize risks. Results were stratified by various factors such as managed care regions, age groups, gender, race, drug type, diagnosis category, total ED visits, and prescribing patterns. Benchmarking data was derived from the 2016 HEDIS Audit Means and Percentiles.
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Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP) Measure Rates Pooja Rangan, Analyst Health Services Advisory Group, Inc. (HSAG) April 24, 2018
Activity Overview Virginia Department of Medical Assistance Services (DMAS) contracted with Health Services Advisory Group, Inc. (HSAG) to calculate the following performance measure: Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP) (NQF #2801) Measurement period: January 1 December 31, 2016 Claims with a first date of service from January 1, 2016 to December 31, 2016 were included. 2
Review of Performance Measure APP assesses the percentage of children and adolescents 1 17 years of age who had a new prescription for an antipsychotic medication and had documentation of psychosocial care as first-line treatment. This measure encourages healthcare providers to attempt safer first-line psychosocial interventions for nonpsychotic conditions, prior to prescribing an antipsychotic medication, which may expose children and adolescents to unnecessarily risks. 3
Measure Calculation Administrative data sources provided by DMAS were used for the rate calculation. Rates were calculated as a percent. Age was determined as of December 31, 2016. Results were calculated for the overall Medicaid managed care population. 4
Reviewing and Interpreting Results Measure results with numerators fewer than 11 were not presented. Since HEDIS specifications were followed, statewide results and age group results can be compared to national benchmarks. 5
Performance Measure Results Virginia total APP measure results: 68.98% This is between the national Medicaid 75th and 90th percentile1 Above results were stratified by the following: Managed care geographic regions (using Federal Information Processing Standards [FIPS] codes) Age group Gender Race category Drug type Primary diagnosis category Total Emergency Department (ED) visits Prescribing pattern 1Benchmarking data is derived from 2016 HEDIS Audit Means and Percentiles 7
Results by Managed Care Geographic Region 8
Results by Managed Care Geographic Region APP Measure Results by Managed Care Geographic Region 76.69% 59.49% 62.83% 68.98% 81.10% 67.16% 68.01% 9
Results by Age Group APP Measure Results by Age Group 80.00% 70.19% 69.60% 68.98% 70.00% 60.00% 50.00% 41.86% Rate 40.00% 30.00% 20.00% 10.00% 0.00% 1-5 Years of Age 6-11 Years of Age 12-17 Years of Age Virginia Total 11
Results by Gender APP Measure Results By Gender 80.00% 69.90% 68.98% 68.32% 70.00% 60.00% 50.00% Rate 40.00% 30.00% 20.00% 10.00% 0.00% Male Female Virginia Total 13
Results by Race Category APP Measure Results by Race Category 100.00% 90.00% 80.00% 70.81% 68.98% 66.92% 63.16% 60.00% Rate 40.00% 20.00% 0.00% White Black/African American Hispanic More than one race/Other/Unknown Virginia Total *Due to small numerators (i.e., less than 11), the following race categories were not reported: Asian, Southeast Asian/Pacific Islander. 15
Results by Drug Type APP Measure Results by Drug Type 100.00% 74.29% 80.00% 72.10% 70.59% 69.09% 68.88% 66.92% 60.00% Rate 40.00% 20.00% 0.00% Aripiprazole Olanzapine Quetiapine fumarate Risperidone Ziprasidone HCL Virginia Total: Second-generation Antipsychotic Medications *Due to small numerators (i.e., less than 11), the following drug types were not reported: First-generation Antipsychotic Medications: Chlorpromazine HCL, Haloperidol, Perphenazine, and Virginia Total for First-generation Antipsychotic Medications; Second-generation Antipsychotic Medications: Asenapine, Lurasidone, and Paliperidone. 17
Results by Primary Diagnosis Category APP Measure Results by Primary Diagnosis Category 100.00% 82.88% 79.49% 80.00% 73.93% 73.91% 68.98% 60.00% 53.33% Rate 34.90% 40.00% 20.00% 0.00% Attention-deficit conduct and disruptive behavior disorders Mood disorders Anxiety disorders Adjustment disorders Disorders usually diagnosed in infancy childhood or adolescence Other Virginia Total 19
Results by Total ED Visits APP Measure Results by Total ED Visits 60.00% 50.00% 46.52% 46.08% 45.10% 40.00% Rate 30.00% 20.00% 10.00% 0.00% Numerator Negative Members Numerator Positive Members Virginia Total 21
Results by Prescribing Pattern APP Measure Results by Prescribing Pattern 80.00% 71.03% 70.90% 70.67% 69.32% 68.98% 64.35% 63.03% 60.00% Rate 40.00% 20.00% 0.00% Rural Total White Rural Black/African American Rural Non-Rural Total White Non-Rural Black/African American Non-Rural Virginia Total *Due to small numerators (i.e., less than 11), the following prescribing patterns were not reported: Other Rural and Other Non- Rural. 23
Questions? 24
Thank you! Pooja Rangan PRangan@hsag.com 25
