MIPS # 001 Diabetes: Hemoglobin A1c (HbA1c) Poor Control (> 9%)

MEASURE DESCRIPTION

Percentage of patients 18-75 years of age with diabetes who had hemoglobin A1c > 9.0% during the measurement period.

 Numerator

Patients with diabetes with a visit during the measurement period whose most recent HbA1c level (performed during the measurement period) is >9.0% or is missing or was not performed during the measurement period.

 Denominator

Patients 18-75 years of age by the end of the measurement period, with diabetes with a visit during the measurement period

Exclusion/Exceptions

  • Exclude patients 66 and older by the end of the measurement period with an indication of frailty for any part of the measurement period who also meet any of the following advanced illness criteria:

    • Advanced illness with two outpatient encounters during the measurement period or the year prior

    • Advanced illness with one inpatient encounter during the measurement period or the year prior

    • Taking dementia medications during the measurement period or the year prior

  • Patients receiving palliative care for any part of the measurement period

  • Patients in hospice for any part of the measurement period

  • Patients 66 and older by the end of the measurement period who are living long term in a nursing home any time on or before the end of the measurement period

 Scoring

Up to 10 points

 RESOURCES

CMS 2024 Specifications

001 Diabetes Workflow in iKM.pdf
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