April 6, 2023
Many patients discharged from the emergency department (ED) require urgent follow-up care with their providers due to their high-risk chronic conditions. An ED discharge is often based on the presumption of continued care.
The Follow Up After Emergency Department Visit for People with Multiple High-Risk Chronic Conditions (FMC) HEDIS measure focuses on the percentage of members age 18 and older with multiple high-risk chronic conditions who had a follow-up visit within seven days of an emergency department visit.
There are many ways to conduct a follow-up visit, including:
- Outpatient
- Telephone
- Transitional care management
- Case management
- Complex care management
- Outpatient or telehealth behavioral health
- Intensive outpatient encounter or partial hospitalization
- Community mental health center
- Electroconvulsive therapy
- Telehealth
- Observation
- E-visit
- Virtual check-in or domiciliary/rest home visits.
Read the FMC Tip Sheet to learn more about this measure, including information about eligible chronic conditions, exclusions, best practices, and documentation requirements.
For more information, contact ProviderClinicalConsulting@Premera.com.
Healthcare Effectiveness Data Information Set. HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).