Diabetes Quality Improvement Project Measures
These measures will become a mandatory part of the Health Plan Employer Data and Information Set (HEDIS) in 2000.
o HbA1c testing: One or more HbA1c test(s) conducted during the reporting year.
o Poor HbA1c control: The most recent HbA1c level (performed during the reporting year) is greater than 9.5% as documented through automated laboratory data and/or medical record review. If there is no HbA1c value during the reporting year, the value is considered to be exceeding the threshold (i.e., no test is counted as poor HbA1c control).
o Eye exam: An eye screening for diabetic retinal disease by an optometrist or ophthalmologist during the reporting year. If certain patient criteria are fulfilled, eye exams from the prior year may satisfy this requirement.
o Lipid profile: A low-density lipoprotein (LDL) test during the reporting year or the year prior to the reporting year.
o Lipid control: The most recent LDL (performed during the reporting year or the year prior) is less than 130 mg/dL. If there is no LDL value within the last two reporting years, the value is recorded as exceeding the threshold.
o Monitoring for diabetic nephropathy: Screening for nephropathy or evidence of already having nephropathy.
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