Periodically, we spotlight a particular Healthcare Effectiveness Data and Information Set (HEDIS) quality of care measure and offer related clinical resources. In this issue, we highlight the Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (IET) HEDIS measure, which focuses on drug and alcohol treatment services.
What is the IET measure?
The IET measure monitors the percentage of adolescent and adult members with a new episode of alcohol or other drug (AOD) abuse or dependence who received the following:
- Initiation of AOD Treatment — The percentage of members who initiate treatment through an inpatient AOD admission, outpatient visit, intensive outpatient encounter or partial hospitalization, telehealth or medication assisted treatment (MAT) within 14 days of the diagnosis.
- Engagement of AOD Treatment — The percentage of members who initiated treatment and who had two or more additional AOD services or MAT within 34 days of the initiation visit.
Screening tools are available to assist you in assessing the severity of substance use and identifying the appropriate level of treatment. Some examples that Harvard Pilgrim recommends include:
Optum/UBH (Harvard Pilgrim’s behavioral health partner) can help with referrals for outpatient behavioral health services by locating in-network services — including chemical dependency services and providers of specialized treatments — and locating practitioners to provide initial screening evaluations and, if needed, subsequent psychological or neuropsychological testing referrals.
To refer a patient for behavioral health services, call Optum at 888-777-4742. To speak with an Optum clinician to discuss treatment options, call the Optum Physicians Consultation service at 800-292-2922.
Telehealth as a treatment option
As a reminder, Harvard Pilgrim now offers telehealth as a treatment option for behavioral health, including AOD abuse or dependence, via Doctor On Demand’s network of exclusive telehealth providers.