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Optimal Diabetes Care

CBE ID
0729
1.4 Project
Primary Care and Chronic Illness
Endorsed
Endorsement Status
Endorsed
1.1 New or Maintenance
Maintenance
E&M Cycle
Spring 2022
Is Under Review
No
Next Planned Maintenance Review
Primary Care and Chronic Illness Spring 2026
1.3 Measure Description

The percentage of patients 18-75 years of age who had a diagnosis of type 1 or type 2 diabetes and whose diabetes was optimally managed during the measurement period as defined by achieving ALL of the following:
• HbA1c less than 8.0 mg/dL
• Blood Pressure less than 140/90 mmHg
• On a statin medication, unless allowed contraindications or exceptions are present
• Non-tobacco user
• Patient with ischemic vascular disease is on daily aspirin or anti-platelets, unless allowed contraindications or exceptions are present

Please note that while the all-or-none composite measure is considered to be the gold standard, reflecting best patient outcomes, the individual components may be measured as well. This is particularly helpful in quality improvement efforts to better understand where opportunities exist in moving the patients toward achieving all of the desired outcomes. Please refer to the additional numerator logic provided for each component.

    • 1.14 Numerator

      The number of patients in the denominator whose diabetes was optimally managed during the measurement period as defined by achieving ALL of the following:
      • The most recent HbA1c in the measurement period has a value less than 8.0 mg/dL
      • The most recent Blood Pressure in the measurement period has a systolic value of less than 140 mmHg AND a diastolic value of less than 90 mmHg
      • On a statin medication, unless allowed contraindications or exceptions are present
      • Patient is not a tobacco user
      • Patient with ischemic vascular disease (Ischemic Vascular Disease Value Set) is on daily aspirin or anti-platelets, unless allowed contraindications or exceptions are present

    • 1.15 Denominator

      Patients ages 18 to 75 with a diagnosis of diabetes (Diabetes Value Set) with any contact during the current or prior measurement period OR had diabetes (Diabetes Value Set) present on an active problem list at any time during the measurement period. Both contacts AND problem list must be queried for diagnosis (Diabetes Value Set).
      AND patient has at least one established patient office visit (Established Pt Diabetes & Vasc Value Set) performed or supervised by an eligible provider in an eligible specialty for any reason during the measurement period.

    • Exclusions

      Valid allowable exclusions include patients who were a permanent resident of a nursing home, pregnant, died or were in hospice or palliative care during the measurement year.

    • Most Recent Endorsement Activity
      Endorsed Primary Care and Chronic Illness Spring 2022
      Initial Endorsement
      Last Updated