Clinical and Quality Measures Toolkits for Behavioral Health Providers
The National Committee for Quality Assurance (NCQA®) has developed measures of healthcare that are quantifiable, comparable and meaningful. They are called the Healthcare Effectiveness Data and Information Set (HEDIS®) measures. NCQA reports that, “HEDIS is one of health care's most widely used performance improvement tools.
191 million people are enrolled in plans that report HEDIS results" to measure performance on important dimensions of care and service. Altogether, HEDIS consists of 90 measures across six domains of care.
Treatment and Follow up for Children Prescribed ADHD Medications (ADD)
Provider Resource: ADHD
Patient Handout: Medication Tracking Log
Screening Tool: Vanderbilt Scale
Follow-up codes after ED discharge mental health
Follow-up codes after hospitalization for mental health
Provider Best Practice Resources:
Antidepression Medication Screening and Management
Focus on Medication Adherence (AMM/SAA)
Provider Resources:
Child and Adolescent Mental Health
Screening Tools:
Treatment Support for Opioid Use Disorders
Treatment for Individuals with Substance Use Disorder (SUD)
Quick Reference Guide
Quick Reference Guide for Substance Use Screening Tools
Screening Tools:
APA DSM5 Level 2 Substance Use Adult -DSM5 adult substance use questionnaire
APA DSM5 Level 2 Substance Use Parent of Child Age 6 to 17- DSM5 child and adolescent substance use questionnaire
AUDIT-C - Adult alcohol use questionnaire
CRAFTT Adolescent alcohol and drug use questionnaires (self or pratitioner administered)
SBIRT -Screening, Brief Intervention, and Referral to Treatment
Member Website:
Live and Work Well
(use access code 'clinician' then click on "Mind & Body")
Provider Resources:
Closing the Gap on Follow-up Care After Discharge
New for 2025: Medical providers now can provide the care required within 7 days of discharge
Optum is committed to fulfilling our mission and vision to help people live their lives to the fullest and to be a constructive and transformational force in the health care system. The Quality Program's mission is to support the Optum clinical mission, vision and values by effectively managing the quality of services provided to its members.
Our Quality Program supports the efforts of practitioners and providers through information analysis and sharing, education, administrative support, and behavioral health clinical quality management expertise.
Goals of the Quality Improvement Program
Optimal quality behavioral health care is achieved through a close and active partnership among Optum, individual members and all healthcare practitioners and providers.
In order to achieve its overall goals, the QI Program strives to:
- Ensure that the care members receive is clinically sound, and based on the most current and relevant clinical knowledge, practices, and technology.
- Build partnerships with behavioral healthcare practitioners to improve member outcomes.
- Improve the continuity and coordination of care delivered to members.
- Identify opportunities and activities that reduce risk and achieve safe treatment environments for members.
Coordination of care among behavioral health clinicians and medical care providers improves the quality of care for your patients Coordination of Care Page on Provider Express.