| Title |
Diabetes: Glycemic Status Assessment Greater Than 9% |
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|---|---|---|---|
| CMS eCQM ID | CMS122v14 | CBE ID | Not Applicable |
| MIPS Quality ID | 001 | ||
| Measure Steward | National Committee for Quality Assurance | ||
| Description | Percentage of patients 18-75 years of age with diabetes who had a glycemic status assessment (hemoglobin A1c [HbA1c] or glucose management indicator [GMI]) > 9.0% during the measurement period | ||
| Measure Scoring | Proportion | ||
| Measure Type | Intermediate Outcome | ||
| Stratification | None | ||
| Risk Adjustment | None | ||
| Rationale | Diabetes is the seventh leading cause of death in the United States (Centers for Disease Control and Prevention [CDC], 2022a). In 2019, diabetes affected more than 37 million Americans (11.3% of the U.S. population) and killed more than 87,000 people (American Diabetes Association [ADA], 2022a). Diabetes is a long-lasting disease marked by high blood glucose levels, resulting from the body’s inability to produce or use insulin properly (CDC, 2022a). People with diabetes are at increased risk of serious health complications including vision loss, heart disease, stroke, kidney damage, amputation of feet or legs, and premature death (CDC, 2022b).
In 2017, diabetes cost the U.S. an estimated $327 billion: $237 billion in direct medical costs and $90 billion in reduced productivity. This is a 34% increase from the estimated $245 billion spent on diabetes in 2012 (ADA, 2018). Controlling A1c blood levels helps reduce the risk of microvascular complications (eye, kidney and nerve diseases) (ADA, 2022b). |
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| Clinical Recommendation Statement | American Diabetes Association (2023):
– Assess glycemic status (A1C or other glycemic measurement such as time in range or glucose management indicator) at least two times a year in patients who are meeting treatment goals (and who have stable glycemic control). (Level of evidence: E) – An A1C goal for many nonpregnant adults of <7% (53 mmol/mol) without significant hypoglycemia is appropriate. (Level of evidence: A) – On the basis of health care professional judgement and patient preference, achievement of lower A1C levels than the goal of 7% may be acceptable and even beneficial if it can be achieved safely without significant hypoglycemia or other adverse effects of treatment. (Level of evidence: B) – Less stringent A1C goals (such as <8% [64 mmol/mol]) may be appropriate for patients with limited life expectancy or where the harms of treatment are greater than the benefits. Health care professionals should consider deintensification of therapy if appropriate to reduce the risk of hypoglycemia in patients with inappropriate stringent A1C targets. (Level of evidence: B) – Standardized, single-page glucose reports from continuous glucose monitoring (CGM) devices with visual cues, such as the ambulatory glucose profile, should be considered as a standard summary for all CGM devices. Level of evidence: E |
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| Improvement Notation | Lower score indicates better quality | ||
| Definition | None | ||
| Guidance | If the glycemic status assessment (HbA1c or GMI) is in the medical record, the test can be used to determine numerator compliance.
Glycemic status assessment (HbA1c or GMI) must be reported as a percentage (%). If multiple glycemic status assessments were recorded for a single date, use the lowest result. This eCQM is a patient-based measure. This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM. |
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| Initial Population | Patients 18-75 years of age by the end of the measurement period, with diabetes with a visit during the measurement period | ||
| Denominator | Equals Initial Population | ||
| Denominator Exclusions | Exclude patients who are in hospice care for any part of the measurement period.
Exclude patients 66 and older by the end of the measurement period who are living long term in a nursing home any time on or before the end of the measurement period. Exclude patients 66 and older by the end of the measurement period with an indication of frailty for any part of the measurement period who also meet any of the following advanced illness criteria: – Advanced illness diagnosis during the measurement period or the year prior – OR taking dementia medications during the measurement period or the year prior Exclude patients receiving palliative care for any part of the measurement period. |
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| Numerator | Patients whose most recent glycemic status assessment (HbA1c or GMI) (performed during the measurement period) is >9.0% or is missing, or was not performed during the measurement period | ||
| Numerator Exclusions | None | ||
| Denominator Exceptions | None | ||
| Telehealth Eligible | Yes | ||
| Next Version | No Version Available | ||
| Previous Version | CMS122v13 | ||
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