Screening for Depression

By: AvMed News AvMed News

AvMed and Magellan Health are working together to provide physicians with tools to help them better screen their patients for depression. Better screening of AvMed Members will help produce the best health outcomes possible.

Comprehensive screening is the first step in identifying those patients who may be suffering from depression and will help determine the appropriate treatment and level of care for those patients. Magellan’s depression screening program includes three brief, multipurpose, self‐administered Patient Health Questionnaires (PHQ) used to assess depression.

The PHQs, listed below, are endorsed by the National Quality Forum (NQF):

PHQ‐2: Is used to screen for depression, identifying the degree to which an individual experienced depressed mood and anhedonia over the past two weeks.

PHQ‐9: Is used to screen for depression, but also valid for the assessment of depression severity. When used successively during a treatment episode, PHQ‐9 is a practical means to monitor a patient’s response to depression treatment.

PHQ‐A: Is a modified version of PHQ‐9 and sensitive to the adolescent experience of depression. It is an acceptable and efficient tool for early detection and recognition of mental disorders in this high‐risk group.

The National Committee for Quality Assurance (NCQA) requires AvMed to measure and report the percentage of Members 18 years of age and older with a diagnosis of major depression, the rates of those treated with antidepressant medication, and remaining on an antidepressant medication treatment. Specific rates reported are:

Effective Acute Phase Treatment: The percentage of Members who remained on an antidepressant medication for at least 84 days (12 weeks).

• Effective Continuation Phase Treatment: The percentage of Members who remained on an antidepressant medication for at least 180 days (6 months).        

AvMed works closely with our contracted behavioral health partner, Magellan Health, to manage Members with major depression disorder (MDD). It is critical for Members diagnosed with major depression to adhere to their treatment plans.

Here are a few best practices to help improve HEDIS performance and ensure medication adherence:

  • Follow up with patients at critical points in care, such as within seven days of a hospitalization or initiation of new treatment plan and within 30 days of dosage or other medication changes to ensure he or she is taking the medication as prescribed and the patient is not experiencing side effects.
  • Monitor dosage after 30 days to determine if any adjustment is needed.
  • Instruct patients to call you before discontinuing any medications you prescribe and for uncomfortable or serious side effects.
  • Consider a thorough psychosocial assessment and obtain assistance from Magellan if needed.
  • Refer the patient to a behavioral health provider for psychosocial support and skill building.

An additional option is to consider telebehavioral health. With telebehavioral health, Providers can do everything they do during a regular face‐to‐face office visit — from counseling, diagnosing, and prescribing medication if appropriate — all via a HIPAA-compliant, secure, private online connection.

Through our partnership with Magellan Health, patients have access to a network of qualified behavioral/mental health and substance abuse practitioners including psychiatrists, psychologists, social workers, master’s level therapists and various specialty providers. Over 214 network providers in Florida participate in telebehavioral health.

If you have a patient who would benefit from telebehavioral health, contact Magellan Health to request a behavioral health provider. Or, direct your patients to register online and search for an appropriate Provider.

Providers are encouraged to obtain a signed release of information form (or document the member’s non-authorization). While stigma associated with behavioral healthcare can sometimes inhibit such communication, providers can educate members on the benefits of coordinated care.

Magellan Health can be contacted at 1-800-424-4810. For screening tools and clinical guidelines, click here.