• 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 target trendline in the graph above represents the 90th national benchmark percentile for Medicaid programs across the country. 

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.

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

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“The source for certain health plan measure rates and benchmark (averages and percentiles) data (“the Data”) is Quality Compass® 2022 and is used with the permission of the National Committee for Quality Assurance (“NCQA”). Any analysis, interpretation or conclusion based on the Data is solely that of the authors, and NCQA specifically disclaims responsibility for any such analysis, interpretation or conclusion. Quality Compass is a registered trademark of NCQA. 

The Data comprises audited performance rates and associated benchmarks for Healthcare Effectiveness Data and Information Set measures (“HEDIS® ”) and HEDIS CAHPS® survey measure results. HEDIS measures and specifications were developed by and are owned by NCQA. HEDIS measures and specifications are not clinical guidelines and do not establish standards of medical care. NCQA makes no representations, warranties or endorsement about the quality of any organization or clinician that uses or reports performance measures or any data or rates calculated using HEDIS measures and specifications, and NCQA has no liability to anyone who relies on such measures or specifications. 

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