Feb. 5, 2015

2014 HEDIS^® Antidepressant Medication Management Results

The Healthcare Effectiveness Data and Information Set (HEDIS) is a tool used by more than 90 percent of America's health plans, and it measures performance on important dimensions of care and service, including behavioral health. Because so many plans collect HEDIS data and the measures are so specifically defined, HEDIS makes it possible to compare performance among health plans.

The Antidepressant Medication Management HEDIS metric includes members who:

• Are 18 years of age or older,
• have been diagnosed with major depression,
• were newly treated with antidepressant medication, and
• remained on an antidepressant medication treatment.

To evaluate if members are receiving the maximum benefit from an initiated antidepressant medication regimen, two rates are reported:

• Effective Acute Phase: Those who stayed on an antidepressant for at least 12 weeks (84 days)
• Effective Continuation Phase: Those who stayed on an antidepressant for at least 6 months (180 days) 

What were the Blue Cross and Blue Shield of Oklahoma (BCBSOK) member results?
HEDIS measurements are calculated annually and compared to national averages. For patients who stayed on an antidepressant for at least 12 weeks the 2014 national average was 64.26 percent, and the average for BCBSOK members was 64.09 percent. For patients who stayed on an antidepressant for at least six months the 2014 national average was 48.70 percent, and the average for BCBSOK members was 45.41 percent.

What is BCBSOK doing to help?
We have provided an educational article to members about the importance of staying on antidepressant medication, and we continue to work with our pharmacy and reporting departments to develop programs to assist members with their medications. If you have a patient you believe is not fully compliant with an antidepressant regime and you believe therapy would also be beneficial, we can help.

You or the patient can contact us via the BCBSOK number on the back of the member’s ID card. We can help them locate a behavioral health therapist, enroll them in one of our case management programs, or help coordinate care so that the patient is more successful with their antidepressant medication regime.

For additional information, visit the Clinical Resources/Behavioral Health Care Management Program section of our website at bcbsok.com/provider.

*HEDIS-like rates. Figures have not been audited externally.