Comprehensive Diabetes Care (CDC)

Assesses adults 18–75 years of age with diabetes (type 1 and type 2) who had each of the following:

  • Hemoglobin A1c (HbA1c) testing.
  • HbA1c poor control (>9.0%).
  • HbA1c control (<8.0%).
  • Eye exam (retinal) performed.
  • Medical attention for nephropathy.*
  • BP control (<140/90 mm Hg).

*This indicator is only reported for the Medicare product line.

Why It Matters

Diabetes is a complex group of diseases marked by high blood glucose (blood sugar) due to the body’s inability to make or use insulin. Left unmanaged, diabetes can lead to serious complications, including heart disease, stroke, hypertension, blindness, kidney disease, diseases of the nervous system, amputations and premature death.1 Proper diabetes management is essential to control blood glucose, reduce risks for complications and prolong life. With support from health care providers, patients can manage their diabetes with self-care, taking medications as instructed, eating a healthy diet, being physically active and quitting smoking.1

Results – National Averages

Blood Pressure Control (<140/90 mm Hg)

Measure YearCommerical HMOCommercial PPOMedicaid HMOMedicare HMOMedicare PPO
202264.455.863.670.466
202162.950.660.367.966.3
202054.549.058.264.965.0
201965.051.362.1§§
201864.253.662.169.567.3
201762.250.362.767.463.6
201661.650.559.763.960.6
201560.249.759.061.955.2
201464.658.761.965.060.1
201365.058.560.465.662.2
201266.558.358.963.361.2
201165.859.460.963.160.3
201065.751.160.462.355.6
200965.146.359.860.549.0
200865.60.356.959.50.3
200763.90.155.658.90.3

Eye Exams

Measure YearCommerical HMOCommercial PPOMedicaid HMOMedicare HMOMedicare PPO
202251.64951.571.869.2
202151.148.450.871.169.7
202049.046.950.668.368.5
201955.150.357.2§§
201855.949.657.474.272.7
201755.049.057.271.971.1
201653.647.554.970.469.6
201553.747.152.768.868.4
201456.248.754.468.568.4
201355.746.953.668.566.0
201256.848.853.266.864.6
201156.948.453.366.063.8
201057.745.553.164.662.3
200956.542.652.763.559.4
200856.535.852.860.852.2
200755.034.049.862.750.4
200654.636.151.462.353.8
200554.842.748.666.553.8
200450.9-44.967.2-
200348.8-45.064.9-
200251.7-46.868.4-
200152.1-46.466.0-
200048.1----
199945.3----

HbA1c Screening

Measure YearCommerical HMOCommercial PPOMedicaid HMOMedicare HMOMedicare PPO
202191.189.485.393.994.2
202088.087.082.891.992.7
201991.790.088.2§§
201891.390.287.894.493.9
201791.289.887.693.793.5
201690.689.386.793.593.6
201590.188.886.093.292.7
201490.588.386.392.892.4
201389.987.383.892.391.7
201290.187.283.091.491.0
201190.087.082.591.091.1
201089.985.282.090.490.6
200989.283.380.689.689.3
200889.079.580.588.385.7
200788.175.677.388.181.9
200687.572.178.087.283.3
200587.582.876.188.980.0
200486.5-75.989.1-
200384.6-74.887.9-
200282.6-73.085.0-
200181.4-71.685.7-
200078.4----
199975.0----

HbA1c Control (<7% for a selected population)

Measure YearCommercial HMOCommercial PPOMedicaid HMOMedicare HMOMedicare PPO
201938.434.934.7§§

HbA1c Control (<8.0%)

Measure YearCommercial HMOCommercial PPOMedicaid HMOMedicare HMOMedicare PPO
202261.853.850.968.569.7
202159.249.948.366.569
202053.248.445.062.967.1
201958.948.949.5§§
201858.251.148.766.168.4
201757.647.949.464.467.2
201656.046.647.162.966.3
201555.346.645.562.763.8
201457.552.646.564.865.2
201358.952.845.565.564.1
201261.354.546.564.362.8
201161.255.248.165.263.2
201062.350.246.965.657.3
200961.648.045.763.751.8

Poor HbA1c Control (>9.0%)

*Lower rates signify better performance
Measure YearCommerical HMOCommercial PPOMedicaid HMOMedicare HMOMedicare PPO
202228.536.640.321.921.8
202130.742.542.323.521.7
202037.543.945.427.423.4
201929.840.140.4§§
201830.337.841.222.519.9
201731.741.240.525.422.3
201633.042.543.326.323.3
201533.844.345.427.426.5
201431.137.343.624.924.9
201330.537.745.625.326.6
201228.535.244.727.129.3
201128.333.543.026.528.8
201027.346.644.025.935.2
200928.244.644.928.041.3
200828.474.444.829.467.0
200729.484.148.029.074.7
200629.675.948.727.371.8
200529.755.449.223.627.3
200430.7-48.622.3-
200332.0-48.623.4-
200233.9-48.948.9-
200136.9-48.326.8-
200042.5----
199944.9----

Monitoring Nephropathy

Measure YearCommerical HMOCommercial PPOMedicaid HMOMedicare HMOMedicare PPO
202194.994.9
2020---94.094.5
201990.188.789.7§§
201890.388.689.995.594.9
201790.488.290.195.795.1
201690.288.189.995.695.3
201590.487.490.095.594.7
201485.480.480.992.090.0
201384.578.979.091.189.4
201284.378.678,490.088.3
201183.877.977.889.988.1
201083.674.377.789.287.3
200982.969.976.988.685.2
200882.465.976.687.982.1
200780.664.274.385.781.7
200679.760.774.685.483.0
200555.144.448.960.351.5
200452.0-46.758.6-
200348.2-43.753.6-
200251.8-48.257.3-
200146.3-42.351.9-
200041.3----
199936.0----

§ Not available due to CMS suspension of data reporting during COVID-19 pandemic.

This State of Healthcare Quality Report classifies health plans differently than NCQA’s Quality Compass. HMO corresponds to All LOBs (excluding PPO and EPO) within Quality Compass. PPO corresponds to PPO and EPO within Quality Compass.

Figures do not account for changes in the underlying measure that could break trending. Contact Information Products via my.ncqa.org for analysis that accounts for trend breaks.

References

  1. Centers for Disease Control and Prevention (CDC). 2020. “National diabetes statistics report, 2020.” Atlanta, GA: U.S. Department of Health and Human Services. https://www.cdc.gov/diabetes/data/statistics-report/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fdiabetes%2Fdata%2Fstatistics%2Fstatistics-report.html

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