Optimal Diabetes Care
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
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Group/Practice
Measure Info
ACP does not support “Optimal Diabetes Care” for application at the group practice level because of uncertain validity. This performance measure's components are critical to managing diabetes care. However, the all-or-none scoring approach, i.e., a physician must meet all components of the measure to receive a score, could lead to unintended consequences, such as cherry-picking patients to improve performance rates. The performance measure will not differentiate among those group practices that are meeting most of the components from those who are meeting none of the components. The cost implications of the different medications also play a role. A patient with difficulty affording blood pressure medication may have difficulty obtaining a statin medication. While ACP appreciates that the developers have incorporated a risk adjustment approach to account for differences in diabetes management based on social risk factors, it does not mitigate the testing data which demonstrates removing one of the components can significantly improve performance rates for the overall performance measure. Finally, the measure uses data buried in medical records, resulting in a high burden for physicians.