New HEDIS Star measure highlights importance of follow-up care after emergency department visits

Many patients with high-risk chronic conditions require important follow-up care after they’re discharged from the emergency department. Often, an emergency department discharge is based on the presumption that patients will continue necessary care with their health care providers.

The importance of continued care is highlighted in a new HEDIS^® Star measure, Follow-Up After Emergency Department Visit for People with Multiple High-Risk Chronic Conditions (FMC). The measure focuses on the percentage of members who are ages 18 and older with multiple high-risk chronic conditions and who had a follow-up appointment within seven days of an emergency department visit.

Ways patients should follow up after an emergency department visit   

There are several types of follow-up care that meet the criteria for FMC. Patients can follow up with a provider through an outpatient appointment by phone or virtually.

Other types of follow-up care include:  

• Transitional care management
• Case management
• Complex care management
• Outpatient or telehealth visits for behavioral health
• Intensive outpatient encounter or partial hospitalization
• Community mental health center
• Electroconvulsive therapy
• Observation

Read the tip sheet on FMC for information about eligible chronic conditions, exclusions, best practices, documentation requirements and more.  

HEDIS^®, which stands for Healthcare Effectiveness Data Information Set, is a registered trademark of the National Committee for Quality Assurance, or NCQA.