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The HEDIS® behavioral health F-series measures focus on timely transitions of care following behavioral health and substance use-related hospitalizations or emergency department visits. These measures highlight the importance of connecting members to follow-up care within 7 days to support recovery and improve outcomes. They include: •           Follow-Up After Hospitalization for Mental Illness (FUH) •           Follow-Up After Emergency Department Visit for Mental Illness (FUM) •           Follow-Up After High-Intensity Care for Substance Use Disorder (FUI) •           Follow-Up After Emergency Department Visit for Substance Use (FUA) The days immediately following discharge are critical. Without timely follow-up, members may experience worsening symptoms, challenges with treatment adherence, or an increased risk

Depression is one of the most common behavioral health conditions affecting adolescents and adults, yet many individuals remain undiagnosed and untreated. The Depression Screening and Follow-Up for Adolescents and Adults (DSF-E) measure highlights the importance of screening members for depression and ensuring appropriate follow-up when a screening result is positive. Primary Care Providers are often the first point of contact for members and play a critical role in identifying behavioral health concerns early. Providers are encouraged to incorporate depression screening into every annual wellness visit, particularly for adolescents and young adults, as early identification can lead to timely intervention and improved

Women's preventive screenings are essential for detecting health conditions early, improving outcomes, and supporting lifelong health. Whether discussing breast cancer screening, cervical cancer screening, colorectal cancer screening, or chlamydia screening, every patient encounter provides an opportunity to review preventive care needs and close gaps in care. One area of ongoing concern is chlamydia screening, where screening rates continue to present challenges nationally and across health plans. Because chlamydia is often asymptomatic, many women may not realize they are at risk or understand the importance of routine screening. Providers can help address this gap by normalizing conversations about sexual health and incorporating

Effective for Dates of Service in 2026, Payment Year 2027 Beginning with the mid-year risk score run in PY2027, CMS will exclude DOS 2026 diagnosis submissions on unlinked Chart Review Records (CRRs) from Medicare Advantage risk score calculations. Diagnoses not linked to an eligible encounter may no longer be reflected in member risk scores. Wellcare By Fidelis Care’s Operational Approach In response, Wellcare By Fidelis Care will hold all unlinked ASM/Active DX and retrospective chart review submissions until they can be linked to an eligible encounter. To ensure accurate risk score captures, timely claim submission is now essential so diagnoses can be appropriately