Some U.S. Screening Data Will Be Reported in September 2022

By Joy Burkhard, MBA; Rebecca Britt, MA and Sarah Johanek, MPH

At the urging of health care leaders, like 2020 Mom, and with funding from the California Health Care Foundation and the ZOMA Foundation, the National Committee for Quality Assurance (NCQA) developed two measures for health insurance plans to monitor how often screening and follow up for maternal depression is occurring in the U.S.

The Prenatal Depression Screening and Follow-Up and Postpartum Depression Screening and Follow-Up measures were published in the Healthcare Effectiveness Data and Information Set® (HEDIS) in 2019. Following are links to the final measures on the NCQA website:
Prenatal Depression Screening and Follow-up
Postpartum Depression Screening and Follow-up

How is Screening Measured?

HEDIS measurement data is collected by health insurers. The postpartum screening and follow-up measure data is collected by health insurers via electronic data capture systems, not just medical records or claims data, as HEDIS measures were limited to in the past. This means screening from any type of provider (OB, Midwife, Pediatrician) as well as non-providers, like insurance plan high-risk pregnancy case managers, could be counted.

What Do We Think About The E-Measure Approach?

Though 2020 Mom supports a no-wrong door approach, we have been advocating for screening to occur in the health delivery system, and by obstetric providers as the medical home. Moving upstream to screen in pregnancy (and even prior to conception) is critical to detect and treat MMH disorders and prevent preterm birth and low-birth-weight babies. Further, treating depression and anxiety during pregnancy mitigates risk for these debilitating disorders from occurring in the postpartum period.

Starting in 2022, the measure results will be publicly reported by private plans (non-Medicaid plans) via NCQA through their annual “Quality Compass” report. 2020 Mom will be reporting results to the field, through a grant made by the ZOMA Foundation.

What About Medicaid Plans?

In 2020, 2020 Mom, in a sign-on letter of over 50 organizations, urged The Centers for Medicare & Medicaid Services (CMS) and its Center for Medicaid and CHIP Services (CMCS) to add these two depression screening measures to their Adult Measure Core Set.

According to the 2021 Child and Adult Core Set Review Workgroup Final Report (“Workgroup final report”), the workgroup recommended CMS adopt the Postpartum Depressions Screening and Follow-Up measure as part of the Adult Core Measure Set. This was a significant win for maternal mental health.

Although there were no detractors noted by the review workgroup in the final report, the prenatal screening measure was not recommended to be added into the Core Set. Additionally, this measure has not been proposed for consideration at the last two Annual Reviews.

Further, there was a memo issued in December 2021, indicating that the proprietary nature of the NCQA eMeasure data collection was being evaluated by CMS for the postpartum depression measure. Ultimately, the measure was not reported on, in 2021, though the measure also hasn’t been removed from the Core Set.

CMS informed 2020 Mom, their leaders are still working with NCQA, the measure steward, to assess the feasibility of inclusion of the postpartum depression screening measure in the annual update.

In the meantime, 2020 Mom continued to call on the Core Set committee to recommend the inclusion of the pregnancy screening measures, though recommendation by the committee is unlikely, until CMS reports the postpartum measures. Read our letter here.

Medicaid Plans - Some States Will Report

Despite these delays, some state Medicaid agencies are requiring their Medicaid Managed Care plans to report on the postpartum depression screening measure.

Stay Abreast of Change

In October, national depression screening awareness month, 2020 Mom will be hosting a webinar with NCQA and others to discuss the HEDIS measure results. Sign up for eNews to be sure not to miss an update.