OBJECTIVES: To estimate performance of the quality measure ‘Adherence to Antipsychotic Medications for Individuals with Schizophrenia’ (SAA-AD) and examine the association between the SAA-AD measure performance and healthcare resource utilization among beneficiaries of Mississippi Medicaid.

METHODS: An observational, cohort study was conducted using Mississippi Medicaid administrative claims data gathered between January 1, 2020, and December 31, 2021. SAA-AD measure reports the percentage of beneficiaries with schizophrenia or schizoaffective disorder who were dispensed and remained on antipsychotic medication for at least 80% of their treatment period. The 2020 calendar year was used as measurement year to identify number of beneficiaries who achieved a PDC of at least 80% for their antipsychotic medication and the 2021 calendar year was used to identify outcomes resulting from care. Age, sex, race, previous hospitalization, previous ER visit, treatment period, and deyo-charlson comorbidity index were included as covariates. Statistical analyses, including logistic regression models, were conducted using SAS v9.4.

RESULTS: A total of 3,722 eligible patients were identified, with a mean age of 42.74 years (SD:74); 54.7% were males, 62.9% were Black, and 54% of the measure population had a proportion of days covered (PDC) score of 0.80 or more and were considered adherent (n=2,008). Logistic regression models showed significant relationship between adherence to antipsychotic medications and mental health-related hospitalization (OR = 0.577, 95% CI: 0.412, 0.807) and any-cause ER visit (OR=0.790, 95% CI: 0.645, 0.968) and non-significant relationship with any-cause hospitalization (OR=1.094, 95% CI: 0.846, 1.413) and mental health-related ER visit (OR=0.736, 95% CI: 0.483, 1.123) after accounting for proposed confounders.

CONCLUSIONS: This study found that the SAA-AD measure significantly predicted mental health-related hospitalizations and any-cause ER visits among Medicaid beneficiaries with schizophrenia treated with antipsychotics. Further research is needed to estimate the performance of the measure with additional outcomes and in more states.