Health plans to track new diabetes measures
Health plans to track new diabetes measures
NCQA, FACCT agree on indicators
By the year 2000, health plans will be required to track clinical and process outcomes related to diabetes, making it the first disease with a widely used, comprehensive set of measures designed to assess overall care.
Health plans will begin incorporating the measures in 1999, as the measurement set produced by the Diabetes Quality Improvement Project, (DQIP) a coalition of public and private health care organizations, becomes a voluntary part of the National Committee for Quality Assurance (NCQA) assessment program, says spokesman Brian Shilling.
It wasn't hard for major health care organizations to agree on diabetes as a target for outcomes measurement and quality improvement. Nationally, more than 16 million people suffer effects of diabetes, although an estimated eight million remain undiagnosed. More than 150,000 people die from diabetes and its complications each year. And the costs related to diabetes are projected to approach $100 billion a year.
That bleak information comes from the Diabetes Quality Improvement Project (DQIP), a collaborative of the American Academy of Family Physicians, American College of Physicians, American Diabetes Association, Foundation for Accountability, Health Care Financing Administration, NCQA, and the Department of Veterans Affairs.
DQIP's accountability set is designed to enable comparisons of performance among both health plans and providers. DQIP also established additional measures that could be used for quality improvement and is developing patient-reported measures related to self-management education, satisfaction with care, access to care, functional health status, and lost time from daily activities.
Here is a summary of the DQIP accountability measures:
· Percentage of patients receiving greater than one glycohemoglobin (HbA1c) test/year.
· Percentage of patients with the highest-risk glucose level (i.e., HbA1c greater than 9.5%).
· Percentage of patients assessed for nephropathy.
· Percentage of patients receiving a lipid profile once in two years.
· Percentage of patients with a low-density lipoprotein less than 130 mg/dl.
· Percentage of patients with blood pressure less than 140/90 mm Hg.
· Percentage of patients receiving a periodic dilated eye exam.
· Percentage of patients receiving an annual documented foot exam.
Editor's note: Some of the measures have exclusions based on age or comorbidity, or based on the results from a previous exam. Most measures apply to people with diabetes between 10 and 75 years of age, regardless of type of diabetes. For more information on the DQIP, contact the Foundation for Accountability, 520 S.W. Sixth Ave., Suite 700, Portland, OR 97204. Telephone: (503) 223-2228. Fax: (503) 223-4336. World Wide Web: http://www.facct.org/DQIP.html.
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