Important Facts for HEDIS (Healthcare Effectiveness Data and Information Set) Measures: Diabetes Care - Hemoglobin A1c (A1C)

Definition

Percentage of health plan members with diabetes who had their Hemoglobin A1c tested within the last year.

Numerator

Number of sampled health plan members with diabetes who had their Hemoglobin A1c tested within the last year.

Denominator

Number of sampled health plan members with diabetes.

Data Interpretation Issues

Evidence from health plan administrative records and survey interviews indicates that the American Association of Diabetes Educators (AADE) and the National Committee for Quality Assurance (NCQA) surveys might substantially underestimate the proportion of persons with diabetes who have a routine A1C test. Note that starting in 2017, Utah commercial HMOs and PPOs are now regarded as functionally the same and are used together in calculating the state averages.

Why Is This Important?

The Hemoglobin A1c (A1C) test measures the level of blood glucose for persons with diabetes. High levels of blood glucose puts people at risk for blindness, kidney disease, and lower extremity infections. With support from their provider, people can can reduce their risk of serious complications by controlling their levels of blood glucose.

Healthy People Objective D-11:

Increase the proportion of adults with diabetes who have a glycosylated hemoglobin measurement at least twice a year
U.S. target: 71.1 percent

How Are We Doing?

The American Diabetes Association recommends an A1C exam about every three months.

What Is Being Done?

The Diabetes Prevention and Control Program has been combined with the Heart Disease and Stroke Program, the Physical Activity, Nutrition and Obesity Program, and a School Health Program. The new program is known as the Healthy Living through Environment, Policy, and Improved Clinical Care (EPICC) Program. One of EPICC's main goals is to decrease the proportion of people with diabetes who have A1Cs greater than 9%. A number of studies show that people who attend diabetes self-management education classes have lower A1C levels. These classes are usually taught by a dietitian, pharmacist, or certified diabetes educator, and have been shown to help individuals develop a variety of skills, including blood sugar monitoring, they need to manage their diabetes. A list of classes is available at [https://livingwell.utah.gov/program.php?grp=diab].