Preschool Measures 21. Psychotropic medication % of enrollees ≤ 5 who receive 6 Numerator: Those in the denominator The use of psychotropic medication Medicaid Claims & Encounter C use for preschool-aged outpatient visits prior to initiating who received ≥ 6 outpatient mental in young children of preschool ages Data children psychotropic (antidepressants, health visits prior to initiating is a practice that is limited by the Pharmacy Files stimulants, antipsychotics) psychotropic medication lack of evidence. Guidelines Professional Files medication treatment published by The Preschool Eligibility Files (All diagnoses) Denominator: Number of children ≤ 5 Psychopharmacology Working years with continuous enrollment with Group (PPWG) recommend treating a mental health diagnosis who had ≥ preschool-aged children with 1 psychotropic medication psychopharmacological prescription fills during the interventions (for up to 12 weeks) measurement year before starting treatment See Appendix C for procedure codes due to the potential impact on their developing brains. 22. Psychosocial visits % of enrollees ≤ 5 who receive Numerator: Those in the denominator Rationale from above measure Medicaid Claims & Encounter C among preschool-aged ≥ 6 outpatient visits after who received ≥ 6 outpatient mental Data children prescribed initiation of psychotropic health visits after initiation of Professional Files psychotropic medications medications (antidepressants, psychotropic medications Eligibility Files stimulants, antipsychotics) (All diagnoses) Denominator: Number of children ≤ 5 years with continuous enrollment who were prescribed a psychotropic medication during the measurement year 23. Use of antipsychotics in % of enrollees under 6 years of Numerator: Those members from the During the past decade rates of Medicaid Claims & Encounter C preschoolers age who are prescribed an denominator aged ≤ 5 who were prescription for psychotropic Data antipsychotic medication during prescribed an antipsychotic medications to preschoolers have Pharmacy file the measurement year medication risen for both Medicaid and privately Eligibility file (All diagnoses) insured populations, particularly the Denominator: The number of children use of antipsychotics and (≤ 18 years) who were enrolled in stimulants. According to a national Medicaid during the measurement study, the rate of antipsychotic use year in privately insured preschoolers more than doubled from 1999 to
Preschool Measures 21. Psychotropic medication use for preschool-aged children (All diagnoses) % of enrollees ≤ 5 who receive 6 outpatient visits prior to initiating psychotropic (antidepressants, stimulants, antipsychotics) medication treatment Numerator: Those in the denominator who received ≥ 6 outpatient mental health visits prior to initiating psychotropic medication Denominator: Number of children ≤ 5 years with continuous enrollment with a mental health diagnosis who had ≥ 1 psychotropic medication prescription fills during the measurement year See Appendix C for procedure codes The use of psychotropic medication in young children of preschool ages is a practice that is limited by the lack of evidence. Guidelines published by The Preschool Psychopharmacology Working Group (PPWG) recommend treating preschool-aged children with interventions (for up to 12 weeks) before starting psychopharmacological treatment due to the potential impact on their developing brains. Medicaid Claims & Encounter Data Pharmacy Files Professional Files Eligibility Files C 22. Psychosocial visits among preschool-aged children prescribed psychotropic medications (All diagnoses) % of enrollees ≤ 5 who receive ≥ 6 outpatient visits after initiation of psychotropic medications (antidepressants, stimulants, antipsychotics) Numerator: Those in the denominator who received ≥ 6 outpatient mental health visits after initiation of psychotropic medications Denominator: Number of children ≤ 5 years with continuous enrollment who were prescribed a psychotropic medication during the measurement year Rationale from above measure Medicaid Claims & Encounter Data Professional Files Eligibility Files C 23. Use of antipsychotics in preschoolers (All diagnoses) % of enrollees under 6 years of age who are prescribed an antipsychotic medication during the measurement year Numerator: Those members from the denominator aged ≤ 5 who were prescribed an antipsychotic medication Denominator: The number of children (≤ 18 years) who were enrolled in Medicaid during the measurement year During the past decade rates of prescription for psychotropic medications to preschoolers have risen for both Medicaid and privately insured populations, particularly the use of antipsychotics and stimulants. According to a national study, the rate of antipsychotic use in privately insured preschoolers more than doubled from 1999 to Medicaid Claims & Encounter Data Pharmacy file Eligibility file C
QualityMeasures.docx