Behavioral Health HEDIS® Measure1
Follow-up care for children
prescribed ADHD medications
Attention deficit hyperactivity disorder (ADHD) is one of the most common behavioral
disorders affecting children. Ten percent of American children have been diagnosed with
ADHD. Primary symptoms include hyperactivity, impulsiveness, and an inability to sustain
attention or concentration. 2
Measure
What to look for:
The percentage of children 6 to 12 years of age with
newly prescribed attention-deficit/hyperactivity disorder
(ADHD) medication that have at least three follow-up
care visits within a 10-month period, one of which is
within 30 days of when the first ADHD medication was
dispensed. Two rates are reported.
Children who have been recently dispensed an ADHD
medication during an outpatient, intensive outpatient, or
partial hospitalization follow-up visit with a practitioner
with prescribing authority.
1. Initiation Phase: The percentage of members 6–12
years of age as of the Index Prescription Start Date
(IPSD) with an ambulatory prescription dispensed
for ADHD medication, which had one follow-up visit
with practitioner with prescribing authority during the
30-day Initiation Phase.
2. Continuation and Maintenance Phase: The
percentage of members 6–12 years of age as of the
IPSD with an ambulatory prescription dispensed for
ADHD medication, who remained on the medication
for at least 210 days and who, in addition to the visit
in the Initiation Phase, had at least two follow-up
visits with a practitioner within 270 days (9 months)
after the Initiation Phase ended. 3
This measurement comes from claims only.
033021 (04-2015)
ADHD Medication List:
Amphetamine-dextroamphetamine
methamphetamine
Atomoxetine
methylphenidate
Dexmethylphenidate
Clonidine
Dextroamphetamine
Guanfacine
Lisdexamfetamine Atomoxeton
Exclusions:
Patients who have had an acute inpatient encounter
with a mental health diagnosis, narcolepsy, or substance
abuse during the 300 days after initial dispensing of the
ADHD medication.
Behavioral Health HEDIS® Measure1
Tips for provider when talking to
the patient:*4
• Explain to parents/caregivers how it is important that
these children be monitored by the provider who
prescribed and evaluated the medication(s).
• Ensure that the patient receives a follow-up visit
within 30 days of a new prescription.
• Ensure that the patient receives at least two more
follow-up visits within nine months to make sure the
treatment is working properly.
Source
1
2
HEDIS is a registered trademark of the National Committee
for Quality Assurance (NCQA).
NCQA “Report Cards” Accessed Jan. 28, 2015
http://www.ncqa.org/ReportCards/HealthPlans/
StateofHealthCareQuality/2014TableofContents/ADHD.aspx
3
Peter Bach et al. HEDIS 2015 Technical Specifications for
Health Plans, (National Committee for Quality Assurance
2015), 172-176 Accessed Jan. 28, 2015
http://www.ncqa.org/portals/0/Followp%20Care%20
for%20Children%20Prescribed%20ADHD%20Medication.
pdf
4
AHRQ, “National Quality Measures Clearinghouse”,
Follow-up Care for Children Prescribed ADHD Medication,
Measure Classification, http://www.qualitymeasures.ahrq.
gov/content.aspx?id=47193, accessed April 14, 2015
* This information is from current medical literature and
provided to you solely for informational purposes. It does
not constitute medical advice and is not intended for use in
medical diagnosis or treatment.