2025 Tennessee Health Link Quality Metrics Table and Thresholds
| # | Core Metric | Source | Description | Threshold |
|---|---|---|---|---|
1 (APM-E) | Metabolic Monitoring for Children and Adolescents on Antipsychotics | HEDIS | The percentage of children and adolescents 1–17 years of age who had two or more antipsychotic prescriptions and had metabolic testing | ≥38.00% |
2 (CBP) | Controlling High Blood Pressure | HEDIS | Percentage of members 18-85 years of age who had a diagnosis of hypertension (HTN) and whose BP was adequately controlled (<140/90 mm Hg) during the measurement year | ≥52.00%
|
3 (EED) | Eye Exam for Patients With Diabetes | HEDIS | Percentage of members 18-75 years of age with diabetes (type 1 and type 2) who had an eye exam (retinal) performed | ≥51.00% |
4 (FUA) | Follow-Up after Substance-Use Visit 30-day | HEDIS | Percentage of ED visits for members 13 years of age and older with a principal diagnosis of substance use disorder (SUD) or any diagnosis of unintentional drug overdose, with a follow up visit. | ≥35.00% |
5 (FUH) | Follow-Up After Hospitalization for Mental Illness Within 7 and 30 days | HEDIS | Percentage of discharges for mental health illness which the member received follow-up to within 7 days of discharge | ≥38.00% |
6 (RTF) | 7- and 30-day Psychiatric Hospital Readmission Rate · 7 days · 30 days | TennCare | Rate of psychiatric hospital or RTF readmissions within 7 days Rate of psychiatric hospital or RTF readmissions within 30 days | ≤5.00% ≤13.00% |
7 (SAA) | Adherence to Antipsychotic Medications for Individuals with Schizophrenia | HEDIS | The % of members 18 years of age or older during the measurement year with schizophrenia or schizoaffective disorder who were dispensed and remained on an antipsychotic medication for at least 80% of their treatment period | ≥65.00% |
8 (SSD) | Diabetes Screening for People With Schizophrenia or Bipolar Disorder | HEDIS | The percentage of members 18–64 years of age with schizophrenia, schizoaffective disorder or bipolar disorder, who were dispensed an antipsychotic medication and had a diabetes screening test during the measurement year | ≥82.00% |
9 (WCV) | Child & Adolescent Well-Care Visits · 3 – 11 years · 12 – 17 years · 18 – 21 years | HEDIS | Percentage of enrolled members 7-21 years of age who had at least one comprehensive well-care visit with a PCP or OB/GYN during the measurement year | ≥65.00% ≥57.00% ≥39.00% |