CMS 122v12: Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Measure: Percentage of patients 18-75 years of age with diabetes who had hemoglobin A1c > 9.0% during the measurement period
Measure Type High Priority Measure Scoring
Outcome Yes A lower percentage indicates better quality
Denominator Patients 18-75 years of age by the end of the measurement period, with diabetes with a visit during the measurement period
Numerator Patients 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 Exceptions None
Denominator Exclusions
  • Patients in hospice care for any part of the measurement period
  • Patients receiving palliative care 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
  • 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

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

    • OR taking dementia medications during the measurement period or the year prior

 

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