WHA’s Annual Integrated Healthcare Association’s (IHA) Align. Measure. Perform (AMP) assessment of Performance Results.
NCQA Measure: Comprehensive Diabetes Care (CDC)
Healthcare providers and Health Plans can help individuals address their diabetes by managing their high blood glucose (blood sugar) with self-care, taking medications as instructed, eating a healthy diet, being physically active and quitting smoking.
Numerator Criteria: HEDIS MY2023
Assesses adults 18-75 years of age with diabetes (type 1 and type 2) who had each of the following:
COMPREHENSIVE
|
WHA MY2021 |
WHA MY2022 |
WHA MY2023 |
WHA NCQA PERCENTILE RANK MY 2023 |
NCQA 90TH %TILE RANK GOAL |
|
HbA1c Poor Control
(>9 %) * |
22.49
|
27.49
|
22.16
|
75th
|
17.61
|
|
HbA1c Control (<8 %)
|
67.97
|
63.26
|
67.53
|
50th
|
72.61
|
|
Diabetic Retinal Eye Exam
|
50.37
|
62.04
|
53.09
|
50th
|
65.96
|
|
Kidney Health Evaluation
|
59.03
|
58.57
|
61.72
|
75th
|
62.13
|
|
18 – 64 years of age
|
58.38
|
57.92
|
61.19
|
75th
|
62.04
|
|
65 – 74 years of age
|
65.22
|
64.03
|
66.45
|
75th
|
68.89
|
|
75 – 85 years of age
|
62.50
|
64.52
|
64.84
|
75th
|
74.19
|
|
BP Control (<140/90)
|
72.13
|
65.45
|
78.35
|
75th
|
79.67
|
|
Received Statin Therapy
|
68.79
|
69.11
|
70.69
|
75th
|
71.4
|
|
Statin Adherence (>80%)
|
71.35
|
72.46
|
73.81
|
50th
|
81.86
|
* Lower is better for this measure
COMPREHENSIVE
|
WHA MY2021 |
WHA MY2022 |
WHA MY2023 |
WHA
|
5 Star
|
|
|
HbA1c Poor Control (>9 %) *
|
17.01
|
14.33
|
14.08 |
|
|
|
|
HbA1c Control (<8 %)
|
74.83
|
79.80
|
79.89 |
4
|
>83
|
|
|
Diabetic Retinal Eye Exam
|
58.88
|
69.06
|
77.01 |
4
|
>79
|
|
|
Kidney Health Evaluation
|
74.15
|
60.43
|
65.21 |
1
|
>97
|
|
|
18 – 64 years of age
|
66.67
|
55.17
|
68.57 |
|
|
|
|
65 – 74 years of age
|
60.33
|
61.09
|
65.61 |
|
|
|
|
75 – 85 years of age
|
64.18
|
60.23
|
62.99 |
|
|
|
|
BP Control (<140/90)
|
74.15
|
70.45
|
79.02 |
|
|
|
|
Received Statin Therapy
|
72.22
|
75.68
|
63.48 |
|
|
|
|
Statin Adherence (>80%)
|
84.62
|
70.54
|
75.42 |
|
|
COMPREHENSIVE
|
WHA MY2021 |
WHA MY2022 |
WHA MY2023 |
CMS QHP
|
|
HbA1c Control (>9 %)
|
|
32.60
|
27.98
|
50th
|
|
Diabetic Retinal Eye Exam
|
43.55
|
49.15
|
63.99
|
50th
|
|
Kidney Health Evaluation
|
74.15
|
54.54
|
47.93
|
50th
|
|
18 – 64 years of age
|
66.67
|
49.89
|
50.11
|
|
|
65 – 74 years of age
|
60.33
|
60.87
|
50.22
|
|
|
75 – 85 years of age
|
64.18
|
100
|
55.56
|
|
|
BP Control (<140/90)
|
59.12
|
58.29
|
64.84
|
25th
|
Patient Population Management
DO YOU KNOW WHERE YOUR DIABETIC PATIENTS ARE?
Many practices with electronic health records are now able to query their systems to identify their diabetic patients. Having a list of your diabetic patients makes it easier for office staff to follow-up on routine lab tests and results, annual eye exams and reach out to your patients who have not been seen recently. Since most primary care practices see a significant number of patients with diabetes, WHA recommends practices start their disease-based population management with diabetes. WHA also offers an innovative virtual diabetes reversal treatment program from Virta Health. Members enrolled in this program are medically supervised as they lower A1c, reduce or eliminate diabetes medications and lose weight.
Standards of care in diabetes. Standards of Care in Diabetes | American Diabetes Association. (n.d.). https://professional.diabetes.org/standards-of-care
Retinopathy, neuropathy, and Foot Care: Standards of care in diabetes—2024 | diabetes care | american diabetes association. (n.d.-a). https://diabetesjournals.org/care/article/47/Supplement_1/S231/153941/12-Retinopathy-Neuropathy-and-Foot-Care-Standards
Centers for Disease Control and Prevention. (n.d.). Clinical guidance for diabetes. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/hcp/clinical-guidance/index.html
U.S. Department of Health and Human Services. (n.d.). What’s new in the 2024 ADA standards of care? National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/professionals/diabetes-discoveries-practice/ada-2024-standards-of-care
Last review date: December 4, 2024