NCQA > Programs > Recognition > Diabetes Recognition Program > Changes to the Diabetes Recognition Program

Frequently Asked Questions

In July, NCQA will release a number of updates to the Diabetes Physician Recognition Program, developed in partnership with the American Diabetes Association. First among the changes involves the program’s name: going forward, it will be known as the Diabetes Recognition Program. Other changes include:

Expansion of eligible health care providers. In addition to physicians, nurse practitioners may apply for Recognition under the Diabetes Recognition Program.
Temporary suspension of the patient satisfaction survey component of application. The survey will be examined for effectiveness and value during the overall program reevaluation planned for 2009/2010.
Timeliness of submitted data. The start date for patient identification and data abstraction must be no more than 180 calendar days prior to the data collection tool submission date.
Inclusion of new HbA1c <8% measure. In 2008, results from studies including ACCORD (Action to Control Cardiovascular Risk in Diabetes) and ADVANCE (Action in Diabetes and Vascular Disease) suggested that aggressive HbA1c management could cause patient safety issues in certain patients. NCQA worked with the Committee on Performance Measurement and a panel of experts on diabetes management to analyze the data and monitor further developments. As a result changes were made to the HEDIS Comprehensive Diabetes Care measures adding a new indicator for HbA1c <8% and adjusting the HbA1c<7% to apply new exclusions. NCQA then worked with the Committee on Physician Programs and a diabetes recognition program advisory committee to determine the implications for Recognition requirements. While guidelines continue to recommend a general HbA1c goal of <7% for most adults with diabetes, they should be individualized and less stringent glycemic goals are appropriate for certain patients. NCQA's expert panels also emphasized that significantly lowering the HbA1c (even if not reaching the target HbA1c) provides a benefit for patients and this benefit could be recognized by adding an HbA1c<8% measure. Scoring has been adjusted to accommodate the new measure while maintaining the same total point allocation for the measures related to level of HbA1c control.
Scoring Changes.The table below specifies revised scoring for the updated standards.

Clinical Measures	Criteria	Points
HbA1c Poor Control >9.0%*	≤15% of patients in sample	12.0
HbA1c Control <8.0%	60% of patients in sample	8.0
HbA1c Control <7.0%	40% of patients in sample	5.0
Blood Pressure Control ≥ 140/90 mm Hg*	≤35% of patients in sample	15.0
Blood Pressure Control <130/80 mm Hg	25% of patients in sample	10.0
Eye Examination	60% of patients in sample	10.0
Smoking Status and Cessation Advice or Treatment	80% of patients in sample	10.0
LDL Control ≥130 mg/dl*	≤37% of patients in sample	10.0
LDL Control <100 mg/dl	36% of patients in sample	10.0
Nephropathy Assessment	80% of patients in sample	5.0
Foot Examination	80% of patients in sample	5.0
Total Points		100.0
Points Needed to Achieve Recognition		75.0

*denotes poor control – lower is better

Additionally, applicants will submit data through a secure, password-protected online tool. The tool allows for online submission of data and application information through a web browser—eliminating the need for mailing a CD to NCQA.

The 2009 version is now available for pre-order on NCQA’s Web site. NCQA will remove the 2006 version of the Diabetes Physician Recognition Program survey tool and materials on June 30, 2009. However, purchasers of the 2006 version of the Diabetes Physician Recognition Program may submit under the 2006 program until January 31, 2010.

Free online workshops will be available for those interested in learning more about the updated program. Watch for information to be posted at http://www.ncqa.org/DRP

For more information about these changes, contact NCQA Customer Support at (888)275-7585.