• This is a Healthcare Effectiveness & Data Information Set (HEDIS®) administrative measure and only includes Medicaid Primary beneficiaries.
• The annual reported rate captures activity during the stated measurement year (MY).

The Healthcare Effectiveness Data and Information Set (HEDIS®) is a registered trademark of NCQA.

The percentage of emergency department (ED) visits for members 13 years of age and older with a principal diagnosis of alcohol or other drug dependence, who had a follow up visit for alcohol or other substance abuse or dependence treatment. The Adult Core Set asks states to report the rate for the subset of members 18 years of age and older (shown above).

Two rates are reported:

1. The percentage of ED visits for which the member received follow-up within 7 days of the ED visit
2. The percentage of ED visits for which the member received follow-up within 30 days of the ED visit

The substantial rate increase from MY2021 to MY2022 is likely due to measure specification changes. 2022 added overdose (toxic effects) codes to the denominator. Overdose has an increased rate of follow-up.  Additionally, the numerator for 2022 added substance disorder medications (e.g., buprenorphine and methadone).  Vermont has a long history and expansive network providing medication assisted treatment for opioid disorders. 

Last updated:  January 2024