New HEDIS? measure will improve testing for those most at risk
July 21, 2020, New York, NY — An estimated 37 million American adults are affected by kidney disease but 90% 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 today in partnership with the National Committee for Quality Assurance (NCQA). The new HEDIS measure will improve kidney disease testing in people with diabetes which is a key risk factor for developing kidney disease.
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% 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, MD, Chief Medical Officer, NKF. “The inclusion of the new measure in the HEDIS Measurement Year 2020 & 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.”
The new measure will assess the percentage of adults with diabetes (age 18-85) who have received both blood and urine kidney tests within the last 12 months. 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 CKD and develop a treatment plan which may include additional testing, lifestyle changes, medicine, and a referral to a nephrologist for further evaluation.
“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,” said Dr. Mary Barton, Vice President, 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 development of the Kidney Health Evaluation HEDIS measure was the result of a large multidisciplinary, multi-stakeholder technical expert panel (TEP) drawing on expertise from governmental, private practice, and health care organization representatives. The TEP was comprised of kidney patients, clinical experts in kidney disease, diabetes, and public health, primary care professionals, researchers, and medical informaticists who contributed to the measure design. The development of the measure was also supported by several NCQA Measurement Advisory Panels including those focused on diabetes, geriatrics and the technical implications of HEDIS.
“Kidney disease is under-diagnosed in primary care with as many as 90% of people unaware they even have the disease. This includes as many as 50% of people with advanced kidney disease who may ultimately require dialysis or a transplant to survive,” added Dr. Vassalotti. “Because kidney disease is asymptomatic in its earliest stages, routine testing among those at highest risk for developing the disease is the only way to diagnose it early and help stave off its life-threatening complications. “
Representatives of the several important 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.
About HEDIS Measures
The Healthcare Effectiveness Data and Information Set (HEDIS) is one of health care’s most widely used performance improvement tools. Approximately 191 million people are enrolled in plans that report HEDIS results. HEDIS includes more than 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, measures collected using electronic clinical data systems. For more information visit ncqa.org.
In the United States, 37 million adults are estimated to have chronic kidney disease—and approximately 90 percent don't know they have it. 1 in 3 American adults are at risk for chronic kidney disease. Risk factors for kidney disease include diabetes, high blood pressure, heart disease, obesity and family history. People of African American, Hispanic, American Indian, Asian or Pacific Islander descent are at increased risk for developing the disease. African Americans are almost 4 times more likely than White Americans to have kidney failure. Hispanics are nearly 1.3 times more likely than non-Hispanics to have kidney failure.
The National Kidney Foundation (NKF) is the largest, most comprehensive, and longstanding patient-centric organization dedicated to the awareness, prevention, and treatment of kidney disease in the U.S. For more information about NKF, visit www.forgedfromreverie.com.
About the National Committee for Quality Assurance
The National Committee for Quality Assurance (NCQA) is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA's Healthcare Effectiveness Data and Information Set (HEDIS) is the most widely used performance measurement tool in health care. NCQA's Web site (ncqa.org) contains information to help consumers, employers and others make more informed health care choices. NCQA can be found online at www.ncqa.org, on Twitter @ncqa, on Facebook at facebook.com/NCQA.org/, and on LinkedIn at linkedin.com/company/ncqa.