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Tackling Depression
Closing the HEDIS DSF-E gap with member-friendly screening + exercise-counseling follow-up.
The 2025 reality
DSF-E is now an MCAS Minimum Performance Level measure.
Miss the 50th-percentile benchmark and DHCS issues a corrective action plan. The capacity gap that gets you there is structural — and it can't be closed with appointments alone.
Our pitch: don't try to scale appointments. Use a follow-up modality that NCQA already accepts and L.A. Care already endorses.
How it works
Screen → Route → Close.
One phone-friendly check-in inside any clinic visit. Sub-90 seconds for most members.
Screen
PHQ-2 → PHQ-9 (adults) or PHQ-A (under 18, parent-completable per L.A. Care guidance)
- EN / ES at launch · 6 more languages on the roadmap
- Item-9 endorsement triggers crisis override regardless of total score
- LOINC 44261-6 (PHQ-9) / 89204-2 (PHQ-9M) recorded with score
Route
Score-driven action by severity band:
- Minimal (0–4): negative screen logged · no follow-up needed
- Mild (5–9): short BREATHE video · DSF-E follow-up in-app
- Moderate (10–14): video + telehealth schedule
- Mod-severe (15–19): video + care-manager outreach in 24h
- Severe (20–27) / Item-9: Carelon Behavioral Health page · 988 · case management
Close the measure
Exercise-counseling video viewed and completed → encounter posted with Z71.82 + Member ID + DOS + LOINC into your ECDS / Lab-File feed.
- Inside the 30-day window — every time
- PSV-survivable: full audit trail of play, completion, language, content
- Bipolar exclusion flag built in
★ The headline
Z71.82 closes DSF-E. L.A. Care has already told its providers so.
"Persons who received follow-up care on or up to 30 days after the date of the first positive screening (31 total days). [Qualifying actions include]: A diagnosis of encounter for exercise counseling."
NCQA HEDIS Measurement Year 2026 · DSF-E numerator · Volume 2 (verbatim)
"A behavioral health encounter, including assessment, therapy, collaborative care or medication management (Behavioral Health Encounter Value Set; ICD-10-CM code Z71.82)."
L.A. Care provider webinar · "Documenting DSF-E and SNS-E Codes Refresher" · September 4, 2024 · Slide 13
NCQA lists exercise-counseling encounters as numerator-qualifying. Your own quality team maps Z71.82 into the Behavioral Health Encounter Value Set and tells your providers it counts. What we do is operationalize that — at scale, in 90 seconds, with a documentation trail your ECDS feed accepts.
Member experience
60–90 seconds, on the phone they already have.
1. Welcome · auto-language
2. PHQ-9 · item-9 override built in
3. Score-routed exercise-counseling video
4. Receipt · plain language + the codes
No login wall. No app store download. No third-party subscription. Member walks out, measure closes.
Plan administrator view
DSF-E compliance, live. Lab-File-ready.
Numerator. Denominator. Audit trail. Coded for L.A. Care's existing supplemental Lab File and ECDS feed.
Engagement layers don't generate a coded follow-up. We do.
Where we go from here
Two questions for the room.
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What does your ECDS feed look like today?
Lab-File supplemental data, EHR export, HIE, or all three? We code to whichever is fastest for your quality team.
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What does success look like?
50th percentile by MY 2025 close? 75th? A specific PCP group out of compliance? Define the bar — we hit it.