HEDIS Measure Targets Untreated Kidney Disease

July 22, 2020
New Kidney Health Evaluation HEDIS Measure will reveal gaps in care for clinicians, healthcare leadership and health plan executives

An estimated 37 million adults are affected by kidney disease, but 90 percent are unaware they even have it. The National Kidney Foundation (NKF) hopes to change that with a new Kidney Health Evaluation for Patients with Diabetes measure announced  in partnership with the National Committee for Quality Assurance (NCQA).

The new HEDIS measure is aimed at improving kidney disease testing in people with diabetes, which is a key risk factor for developing kidney disease. The Healthcare Effectiveness Data and Information Set (HEDIS) is one of healthcare’s most widely used performance improvement tools. HEDIS includes more than 90 measures across six domains of care: effectiveness of care, access/availability of care, experience of care, utilization and risk-adjusted utilization, health plan descriptive information, measures collected using electronic clinical data systems.

Clinical practice guidelines recommend that people with diabetes be routinely tested to detect kidney disease. While the tests associated with kidney disease detection and diagnosis are inexpensive and widely available for routine clinic visits, less than 50 percent of people with diabetes receive both tests annually. The new Kidney Health Evaluation HEDIS Measure will reveal these gaps in care for clinicians, healthcare leadership and health plan executives. 

“For almost two years, NKF has been working in partnership with NCQA to advance the development of the Kidney Health Evaluation measure,” said Joseph Vassalotti, M.D., chief medical officer of NKF.  The NKF-developed Kidney Profile is one strategy to amplify testing that combines the estimated glomerular filtration rate (eGFR), which assesses kidney function, with the urine albumin-creatinine ratio (ACR), which assesses kidney damage. Results of the Kidney Profile provide health plans, physicians and patients with the critical information they need to identify chronic kidney disease (CKD) and develop a treatment plan, which may include additional testing, lifestyle changes, medicine, and a referral to a nephrologist for further evaluation. 

In a statement, Mary Barton, M.D., vice president of performance measurement at NCQA said the new measure’s inclusion only strengthens the HEDIS mission to improve care for all patients, but especially those who live with diabetes and kidney disease. said “We know measures work, in terms of accountability. They give health plans and providers a focal point for improvement. This measure will ultimately lead to better care and improved kidney health across the country.”

Representatives of the several stakeholder groups participated in the development of this measure, including American Diabetes Association, American Medical Group Association, Centers for Disease Control and Prevention, Indian Health Service and the National Institute of Diabetes and Digestive and Kidney Diseases. 

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