Mental Health Screening Initiative for Primary Care

September 2023 Reporting Form

The Mental Health Screening Initiative is intended to:

Augment the standard annual depression screening and follow-up quality measure (i.e. PREV-12), exploring suicidality and anxiety in addition to depression
Improve mental health screening rates and follow-up on positive mental health screening results
Expand electronic documentation and reporting of Mental Health Screening results and follow-up

Reporting on the Mental Health Screening Initiative is designed to capture the rates of screening for mental health disorders for patient encounters in two distinct time periods: calendar year 2022 and the first seven months of 2023.

Please submit report by September 15, 2023

For information regarding requirements and screening tool options, please refer to the guidance and policy documents:

Mental Health Screening Guidance Document

Mental Health Screening Initiative Policy

Mental Health Screening Initiative: September 2023 Reporting

Which describes your practice?

Single-TIN Practice

Single-TIN, Multi-Practice

Single-TIN Practice: Legal Business Name(Required)

Single-TIN, Multi-Practice: Legal Business Name(Required)

For practices that have multiple sites associated with their single TIN#, please find each of your sites listed in this dropdown and submit individual reporting forms for each site.

First name(Required)

First name of person filling out this report

Last name(Required)

Last name of person filling out this report

Email(Required)

In case we need to contact you

Screening - Reporting Period I: Calendar Year 2022

Can your practice provide mental health screening data for the calendar year 2022 baseline period?(Required)

Yes

Number of patients who had qualifying encounters between January 1, 2022-December 31, 2022(Required)

Of those patients who had qualifying encounters between January 1, 2022-December 31, 2022, how many were screened using one of the screening tools listed above?(Required)

Why not? OneCare is interested in learning more about EMR reporting capability across the OneCare network.

Screening - Reporting Period II: First Seven Months of 2023

Number of patients who had qualifying encounters between January 1, 2023-July 31, 2023(Required)

Of those patients who had qualifying encounters between January 1, 2023-July 31, 2023, how many were screened using one of the screening tools listed above?(Required)

If you are unable to provide the required reporting on screening for the first seven months of 2023:

Check here

Please explain any limitations on reporting a 2023 screening rate:(Required)

Mental Health Screening Initiative Follow-Up Reporting

Does your practice electronically capture qualifying follow-up treatment (as outlined in the Mental Health Screening Guidance Document linked above)?

Yes

Acknowledgement of follow-up reporting due in December(Required)

I understand the Mental Health Screening Initiative requires electronic capture of qualifying follow-up treatment and I will report on qualifying follow-up treatment in the report due in December 2023.

Acknowledgement of follow-up reporting due in December(Required)

I understand the Mental Health Screening Initiative requires electronic capture of qualifying follow-up treatment and that best efforts will be made to comply in time to meet the December reporting requirement

Please describe your practice’s progress on electronically capturing and reporting on follow-up:

What support, resources, or advocacy does your practice need to be able to electronically capture and report on qualifying follow-up treatment? OneCare is interested in supporting EMR reporting capability across the OneCare network.

OneCare welcomes any other comments or feedback you would like to share.