Hemoglobin A1c Control for Patients With Diabetes (HBD)

HEDIS Measure

Hemoglobin A1c Control for Patients With Diabetes (HBD)

Line of business: Commercial Medicaid Medicare

Data Collection Method:

Administrative (Claims)
Hybrid (HEDIS Chart Chase)
Supplemental Data Submission

• Standard – Electronic Clinical Data System (ECDS) Layout
• Non-Standard - Medical Record

Measure Description

The percentage of members 18–75 years of age with diabetes (types 1 and 2) whose hemoglobin A1c (HbA1c) was at the following levels during the measurement year:

• HbA1c control (<8.0%).
• HbA1c poor control (>9.0%). (Inverted Measure)

Numerator Compliance

HbA1c Control <8% - The most recent HbA1c test during the measurement year with a result of <8.0%

NOTE: The member is not compliant if the result for the most recent HbA1c test is equal to or greater than 8.0%

HbA1c Poor Control >9% - The most recent HbA1c test during the measurement year with a result of >9.0%

NOTE: The member is not compliant if the result for the most recent HbA1c test is equal to or less than 9.0%

Best Practices

• Order labs prior to members' appointments
• Ensure documentation in the medical record includes the date when the HbA1c was performed, and the result
• Order a diabetes screening test every year and build care gap “alerts” in your electronic medical record
• Follow up with patients to discuss and educate on lab results
• Coordinate care with patients' other providers
• Outreach patients who cancel appointments and reschedule them as soon as possible
• Follow up with patients to discuss and educate on effects of diabetes
• Coordinate care with patients' other providers
• Outreach patients who have not had their eye exam and lab work completed and ask them to complete as soon as possible
• Discuss with member the Importance of screening for diabetes
• Educate the member on symptoms of new-onset diabetes
• Set care gap “alerts” in your electronic medical record

Quality Value Set Directory Coding Tips

HbA1c Lab Test

HbA1c Level Greater Than or Equal To 7.0 and Less Than 8.0

HbA1c Level Less Than 7.0

HbA1c Test Result or Finding

HbA1c Level Greater Than 9.0

HbA1c Level Greater Than or Equal To 8.0 and Less Than or Equal To 9.0