Why Focus on Depression?
Depression significantly impacts both mental and physical health and is a leading cause of disability. The need to develop outcome measures that assess the quality of depression care planted the seed for the HEDIS® Electronic Clinical Data Systems (ECDS) approach.
Patient reported outcome measures are needed to understand depression outcomes, and these data are challenging to collect through typical HEDIS reporting methods. NCQA sees these measures as an opportunity to revolutionize how data are collected and reported.
What Are the Depression Care Measures?
NCQA has five depression care quality measures included in HEDIS. Two measures are focused on depression screening and follow-up during the prenatal and postpartum periods. Three measures were adapted from existing provider and practice level depression measures for inclusion in HEDIS and are described below.
Depression Screening and Follow-up for Adolescents and Adults (DSF)
This measure is adapted from a provider-level measure developed by Quality Insights of Pennsylvania (QIP) (NQF #0418, CMS2). Learn more here. First implemented in HEDIS 2018.
The percentage of members 12 years of age and older who were screened for clinical depression using a standardized tool and, if screened positive, who received follow-up care.
Denominator: All members age ≥12.
Numerator: Screened for depression using a standardized tool and, if screened positive, received follow-up care within 30 days.
Utilization of the PHQ-9 to Monitor Depression Symptoms for Adolescents and Adults (DMS)
This measure is adapted from a depression measure developed by Minnesota Community Measurement (NQF #0712). Learn more at MNCM.org. First implemented in HEDIS 2016.
The percentage of members 12 years of age and older with a diagnosis of depression, who had an outpatient encounter with a PHQ-9 score present in their record in the same assessment period as the encounter.
Denominator: All members age ≥12 who had an encounter during a 4-month period with a diagnosis of major depressive disorder or dysthymia.
Numerator: Documented results of a PHQ-9 tool that was administered at least once during the 4-month period.
Depression Remission or Response for Adolescents and Adults
This measure is adapted from depression measures developed by Minnesota Community Measurement (NQF #0711 and #1884). Learn more at MNCM.org. First implemented in HEDIS 2017.
The percentage of members 12 years of age and older with a diagnosis of depression and an elevated PHQ-9 score, who had evidence of response or remission within 4–8 months after the initial elevated PHQ-9 score.
Denominator: All members age ≥12 with a diagnosis of major depressive disorder or dysthymia who had an initial elevated PHQ-9 score of >9.
Numerator: A follow-up PHQ-9 score documented at 4-8 months after the initial elevated score; a PHQ-9 score <5 documented at 4-8 months following the initial elevated score; a ≥50% reduction in the PHQ-9 score documented at 4-8 months following the initial elevated score.
See NCQA’s FAQ page for more on reporting using data from ECDS.
How Can I Access the Depression Care Measures?
All five depression care measures can be found in HEDIS 2023 Volume 2.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).