Comparison to National Achievement on Comprehensive Diabetes Measures of the NCQA

Table 1 and Figures 1a – 1i below compare Greater Cleveland’s region-wide results on NCQA’s “Comprehensive Diabetes Measures” with the achievement of health plans submitting their results to NCQA in 2006, as reported in NCQA’s State of Health Care Quality in 2007 (available at www.ncqa.org, see pp. 35-37). Most health plans nationwide voluntarily report their information to NCQA to create a Healthcare Effectiveness Data and Information Set (HEDIS), a tool used to measure achievement on important dimensions of care and service.

The 9 standards in NCQA’s Comprehensive Diabetes Measures include some that are included in Better Health’s standards, such as the performance of an eye examination and obtaining at least one Hemoglobin A1c in the one-year measurement period, but they also include standards that are slightly different from those we have chosen (such as the negatively framed “poor glycemic control” standard). Included in the Better Health Greater Cleveland reports for this table and the corresponding figures are 25,634 patients of the 42 partner practices at Care Alliance, Cleveland Clinic, Huron Hospital, Kaiser Permanente, The MetroHealth System, Neighborhood Family Practice and NEON, stratified by insurance. In addition, we provide information to enable comparison of Better Health’s results among the uninsured with health plan data across insurance categories.

The data summarize favorable achievement of Better Health’s partner practices as compared to nationwide averages for health plans: for all nine standards of NCQA’s “Comprehensive Diabetes Care Measures”, and across all insurance categories. Further, because NCQA reports results for insured patients, there are no national data to provide head-to-head comparisons for greater Cleveland’s uninsured patients with diabetes. Nonetheless, our uninsured patients achieve better results for all NCQA standards than the average patients covered in Medicaid health plans nationwide, and, for several standards, than commercially insured patients.


The key results are summarized in Table 1, then graphed in FIgures 1-9 below the table.

Table 1.  Comparison of Regional to National Achievement on Comprehensive Diabetes Measures of the National Committee on Quality Assurance (NCQA)

The nine figures below describe the regional achievement for our 42 EMR and paper-based practices (in total: 25,634 patients) from our seven reporting systems over the period of July 1, 2007 through June 30, 2008, as compared to nationwide health plan data for 2006 as reported by NCQA..
 
Figure 1a. Regional Achievement Compared with Nationwide Health Plan Data: Hemoglobin A1c Testing

Figure 1b. Regional Achievement Compared with Nationwide Health Plan Data: Excellent A1c Control (A1c < 7)

Figure 1c. Regional Achievement Compared with Nationwide Health Plan Data: Poor A1c Control (A1c > 9)
Note that lower values on this standard indicate better results.

Figure 1d. Regional Achievement Compared with Nationwide Health Plan Data: Eye Examination

Figure 1e. Regional Achievement Compared with Nationwide Health Plan Data: Nephropathy Monitoring (Urine Microalbumin Screen or prescription for ACE-inhibitor or ARB medication)

Figure 1f. Regional Achievement Compared with Nationwide Health Plan Data: LDL Cholesterol Screening

Figure 1g. Regional Achievement Compared with Nationwide Health Plan Data: Good LDL Cholesterol Control (LDL < 100)

Figure 1h. Regional Achievement Compared with Nationwide Health Plan Data: Very Good Blood Pressure Control (BP < 130/80)


Figure 1i. Regional Achievement Compared with Nationwide Health Plan Data: Good Blood Pressure Control (BP < 140/90)