FAQ Directory: HEDIS

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2.14.2020 Follow-Up After High-Intensity Care for Substance Use Disorder Direct Transfer instructions state, “Identify direct transfers to an acute inpatient care or residential setting during the 30-day follow-up period.” Should readmissions during the 30-day period also be identified?

No. Only direct transfers during the 30-day follow-up period should be identified. A “direct transfer” is when the discharge date from the first acute inpatient or residential care setting precedes the admission date to a second acute inpatient or residential care setting by one calendar day or less.
If a member had a stay from January 1–5, followed by readmission on January 6 and discharge on January 8, this is considered a direct transfer and the January 8 discharge date is used for reporting.
If a member had a stay from January 1–5 and a stay from January 8–10, this is considered a readmission. The “multiple discharges, visits or events during in a 31-day period” rule applies; the January 5 discharge is used for reporting and the January 10 discharge is dropped.

HEDIS 2020