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% diabetics with A1c under control [OP] NQF Endorsed 2011


Name:% diabetics with A1c under control [OP] NQF Endorsed 2011
Type:Data Element
Source:Agency for Healthcare Research and Quality
Definition:Title: Comprehensive Diabetes Care: HbA1c control (<8.0%) Description: The percentage of members 18 ]75 years of age with diabetes (type 1 and type 2) who had HbA1c control (<8.0%). Numerator: Use automated laboratory data to identify the most recent HbA1c test during the measurement year. The member is numerator compliant if the most recent automated HbA1c level is <8.0%. The member is not numerator compliant if the automated result for the most recent HbA1c test is = 8.0% or is missing a result, or if an HbA1c test was not done during the measurement year. Denominator: Members 18 ]75 years of ages with diabetes. There are two methods to identify members with diabetes: pharmacy data and claims/encounter data. The organization must use both to identify the eligible population, but a member only needs to be identified in one to be included in the measure. Members may be identified as having diabetes during the measurement year or the year prior to the measurement year. Method 1: Pharmacy data. Members who were dispensed insulin or oral hypoglycemics/antihyperglycemics during the measurement year or year prior to the measurement year on an ambulatory basis Method 2: Claim/encounter data. Members who had two face]to]face encounters with a diagnosis of diabetes on different dates of service in an outpatient setting or nonacute inpatient setting, or one face]to]face encounter in an acute inpatient or ED setting during the measurement year or the year prior to the measurement year. The organization may count services that occur over both years. Exclusions: ]Members with a diagnosis of polycystic ovaries who did not have any face]to]face encounters with a diagnosis of diabetes, in any setting, during the measurement year or the year prior to the measurement year. Diagnosis can occur at any time in the memberfs history, but must have occurred by December 31 of the measurement year. ]Members with gestational or steroid]induced diabetes who did not have any faceto] face encounters with a diagnosis of diabetes, in any setting, during the measurement year or the year prior to the measurement year. Diagnosis can occur during the measurement year or the year prior to the measurement year, but must have occurred by December 31 of the measurement year. Time Window: The measurement year or year prior to the measurement year.
Registration Authority:Agency for Healthcare Research and Quality
Status:Incomplete
Comment:QDS Datatypes (HITEP): ]patient age ]active diabetes diagnosis ]active gestational diabetes diagnosis ]active polycystic ovarian disease diagnosis ]steroid induced diabetes active diagnosis ]insulin prescription ]hypoglycemic medication prescription ]antihyperglycemic medication prescription ]HbA1c result
Administrative Note:Note: Should capture HbA1c value to enable stratification as well as broad adherence to all individuals <8.0% [OP] Steward: NCQA Endorsed: Under review 11/21/2008

Recommeded: Endorsement expected within the next month. For retooling, diabetes on the Problem List (ICD]9 or SNOMED), or Medication List with appropriate medication.
Administrative Attributes
Responsible Organization:Agency for Healthcare Research and Quality
Submitting Organization:Agency for Healthcare Research and Quality
Steward Organization:Agency for Healthcare Research and Quality
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