Mental Health Screening Incentive Program

• Complete mental health screenings using one of the following tools:
  • Patient Health Questionnaire (PHQ-2)
  • Patient Health Questionnaire (PHQ-9)
  • Columbia Suicide Severity Rating Scale (C-SSRS);
  • Patient Health Questionnaire for Adolescents (PHQ-A)
  • Edinburgh Postnatal Depression Scale
  • If your practice uses a different mental health screening tool, please contact us to discuss if it can be allowed for the purposes of this initiative.

• Develop and adhere to a follow-up plan for positive mental health screening results that should include:
  • Referral to a provider for additional evaluation, assessment, and treatment
  • Pharmacological intervention(s)
  • Other clinically appropriate interventions or follow-up for the diagnosis or treatment of depression
• Electronically capture mental health screening data
  • Measurement of current screening rates and results
  • Begin development of protocols to track follow-up intervention
• Submit semi-annual reports on screening rates
  • Results should be reported in an aggregate and de-identified format and should not include any protected health information (PHI)
    • The rate can include both attributed and un-attributed lives for all payers
  • The screening rate should be calculated as a percentage based upon:
    • Numerator: the number of patients that received mental health screening
    • Denominator: total patient population eligible for mental health screening
  • Screening rate results should be reported according to the following deadlines:
    • Submission 1: June 14, 2024 (a submission form will be emailed two weeks before)
      Measurement period: January 1, 2024 to May 31, 2024
    • Submission 2: January 2, 2025 (a submission form will be emailed two weeks before)
      Measurement period: January 1, 2024 to December 31, 2024
  • Participants may be randomly audited to confirm reported values are being generated electronically and are being reflected accurate

The OneCare payer-specific annual depression screening metric remains tied to the CMS Prev-12 directions. For more detailed guidance on measuring and reporting mental health screening rates, including measure specifications and how this incentive program aligns with OneCare’s annual measure, please see OneCare Prev-12 Preventative Care and Screening: Screening for Depression and Follow-Up Plan under “2023 Annual Quality Measures” on the OneCare portal.

• The payer-blended target rate for mental health screening in 2024 is 70%
  • Participants achieving this rate will earn maximum payment potential
  • Participants not achieving this rate will be invited to discuss opportunities for improvement with a representative of the OneCare team

• Payment potential:
  • Qualifying participants can earn up to $12.00 per assigned attributed life per year
    • By way of example, a participant with 1,000 assigned attributed lives across all ACO programs would qualify for up to $12,000 in payments

• Payment distribution:
  • First incentive payment: July 2024
    $6.00 per assigned life will be distributed to all participants who have electronically self-reported year-to-date mental health screening rates for the period spanning January 1, 2024, to May 31, 2024 (baseline screening rate)
    • There is no screening rate requirement for this first payment
    • Participants with a baseline screening rate below program target will be required to consult with a OneCare Value-Based Care Team member no later than October 1, 2024 to discuss workflows and obstacles to performance in order to qualify for the second incentive payment
  • Second incentive payment: February 2025
    $6.00 per assigned life will be distributed to participants that have electronically self-reported mental health screening rates by the reporting deadline and achieved a full performance year screening rate equal to or greater than the program target
    • Participants failing to report by the submission deadline and/or meeting the screening rate target will not receive a second incentive payment

OneCare recommends the use of Mental Health Screening Incentive Program payments to enable the electronic capture of mental health follow-up plans, but this is not a requirement of the program.