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Diabetes Care for People with Serious Mental Illness: Hemoglobin A1c (HbA1c) Poor Control (>9.0%)

CBE ID
2607
1.4 Project
Behavioral Health
Endorsed
Endorsement Status
Endorsed
1.1 New or Maintenance
Maintenance
E&M Cycle
Full Year 2013
Is Under Review
No
1.3 Measure Description

The percentage of patients 18-75 years of age with a serious mental illness and diabetes (type 1 and type 2) whose most recent HbA1c level during the measurement year is >9.0%. 

Note: This measure is adapted from an existing health plan measure used in a variety of reporting programs for the general population (NQF #0059: Comprehensive Diabetes Care: Hemoglobin A1c (HbA1c) Control >9.0%). This measure is endorsed by NQF and is stewarded by NCQA.

    • 1.14 Numerator

      Patients whose most recent HbA1c level is greater than 9.0% (poor control) during the measurement year. 

      The intermediate outcome is an out of range result of an HbA1c test, indicating poor control of diabetes. Poor control puts the individual at risk for complications including renal failure, blindness, and neurologic damage. There is no need for risk adjustment for this intermediate outcome measure.

    • 1.15 Denominator

      Patients 18-75 years of age as of December 31 of the measurement year with at least one acute inpatient visit or two outpatient visits for schizophrenia or bipolar I disorder, or at least one inpatient visit for major depression during the measurement year AND diabetes (type 1 and type 2) during the measurement year or the year before.

    • Exclusions

      Patients who do not have a diagnosis of diabetes and meet one of the following criteria are excluded from the measure: 
      -Patients with a diagnosis of polycystic ovaries. 
      -Patients with gestational or steroid-induced diabetes.

    • Most Recent Endorsement Activity
      Endorsed Behavioral Health Project 2013-2015
      Initial Endorsement
      Last Updated