HEDIS® Measures for Diabetic Patient Health

  • May 4, 2023

    In 2022, the HEDIS® Comprehensive Diabetes Care measure was separated into three stand-alone measures. Diabetes care measures are used to evaluate provider and health plan performance and are included in the Centers for Medicare & Medicaid Services (CMS) Medicare Advantage Star Ratings.

    The standalone measures include:

    Patients with diabetes require consistent medical care and monitoring to reduce the risk of severe complications and improve health outcomes. Interventions to improve diabetes outcomes go beyond glycemic control. That is why the comprehensive diabetes care composite measure has been split to enable more focus of the components of diabetes care.

    Review the Diabetes Management tip sheet to learn more about what is included in the measures and ways you can close gaps in care for patients with diabetes. The tip sheets also cover required medical record documentation and claims coding to reduce the need for medical record reviews.

    For more information, contact ProviderClinicalConsulting@Premera.com.

    Healthcare Effectiveness Data and Information Set (HEDIS®) is a registered trademark of the National Committee for Quality Assurance (NCQA).

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