National Kidney Foundation, NCQA Announce Measure to Boost Testing in Patients With Diabetes

July 24, 2020

While clinical guidelines call for those with diabetes to be tested regularly for kidney disease, less than 50% of these patients are tested once a year, according to the National Kidney Foundation.

Kidney disease can be disabling and deadly to patients and costly to health systems, but life-threatening complications can be avoided if the disease is caught early. Too often, that does not happen, according to the National Kidney Foundation (NKF), which estimates that 90% of those affected are unaware.

That’s why NKF and the National Committee for Qualify Assurance (NCQA) have spent the past 2 years developing a new measure to assess how well health systems are doing in testing patients with diabetes for kidney disease. Starting with these patients makes sense, because they have one of the most important risk factors for developing kidney disease, which can lead to loss of renal function and the need for dialysis or kidney transplant.

While clinical guidelines call for those with diabetes to be tested regularly for kidney disease, less than 50% of these patients are tests once a year, according to NKF. The new NCQA Kidney Health Evaluation Measure, which will be included in the Healthcare Effectiveness Data and Information Set (HEDIS), will reveal which practices are missing the mark.

“For almost two years, NKF has been working in partnership with NCQA to advance the development of the Kidney Health Evaluation measure,” Joseph Vassalotti, MD, chief medical officer for NKF, said in a statement. “The inclusion of the new measure in the HEDIS Measurement Year 2020 and Measurement Year 2021 publication is a giant step towards engaging the nation’s health plans, integrated health networks, and individual primary care practitioners to improve the diagnosis of kidney disease.”

HEDIS will include an assessment of the percentage of adults with diabetes aged 18 to 85 years who have received both a blood and a urine test within the past 12 months. A Kidney Profile, developed by NKF, will combine the estimated glomerular filtration rate with the urine albumin-creatinine ratio. The first measures kidney function; the second, kidney damage. The Kidney Profile will give health plans and physicians they need to find those patients who need additional tests, medication, dietary changes, or a referral to a nephrologist.

“We value this successful collaboration with the National Kidney Foundation, especially the new measure we’ve crafted together. Its inclusion only strengthens the HEDIS mission to improve care for all patients, but especially those who live with diabetes and kidney disease,” Mary Barton, MD, vice president of performance measurement, NCQA. “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.”

The Kidney Health Evaluation HEDIS measure came about after a meeting of a multidisciplinary, multistakeholder technical expert panel. Groups that participated in or supported the process included the American Diabetes Association, the American Medical Group Association, CDC, the Indian Health Service, and the National Institute of Diabetes and Digestive and Kidney Diseases.

HEDIS is the most well-known performance tool in health care, capturing data from 191 million people in enrolled in benefit plans. HEDIS covers 90 measures across 6 domains of care:

  • effectiveness of care,
  • access/availability of care,
  • experience of care,
  • utilization and risk-adjusted utilization,
  • health plan descriptive information, and
  • measures collected using electronic health records.