FMC: Follow-Up After Hospitalization for Mental Illness
7-day and 30-day outpatient MH follow-up rates after discharge.
Measure description
7-day and 30-day outpatient MH follow-up rates after discharge.
Eligible population
Members discharged after MH inpatient stay
Performance drivers
Star measure + Medicaid quality measure.
Documentation & PA strategy
Same as EBPC — telehealth bridge appointment scheduled before discharge.
Why HEDIS matters for prior authorization
Health plans align prior authorization criteria with HEDIS measures: documenting your patient meets the HEDIS definition often streamlines or eliminates PA hurdles. For Medicare Advantage in particular, plans are heavily incentivized via Star Ratings to push members and providers toward measure compliance, which translates into faster approvals for measure-aligned services.
Frequently asked questions
What does HEDIS measure FMC measure?
7-day and 30-day outpatient MH follow-up rates after discharge.
What drives performance on this measure?
Star measure + Medicaid quality measure.
How should clinicians document for this measure?
Same as EBPC — telehealth bridge appointment scheduled before discharge.
What is the eligible population?
Members discharged after MH inpatient stay
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