Diabetes care quality measures must be improved, study finds

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Existing diabetes quality metrics do not currently help patients improve their health and diabetes quality measurement must be improved through the adoption of new measures and modernization, according to a June report published in Health Affairs.
 
Current quality measures do not safeguard against inappropriate treatment or overtreatment and in fact incentivize providers to focus on patients most likely to achieve the measures currently in place, rather than those who would benefit the most clinically, the report said.
 
The researchers argue quality measures must connect directly to reimbursement, as in value-based payment models such as accountable care organizations with two-sided risk models, putting forward three propositions intended to guide care management changes.
 
Quality measurement needs to be reimagined to incentivize care that meaningfully improves the health of all people with diabetes while reducing administrative burden, the report stated.
 
The researchers class the measures across the six domains of quality, including effectiveness, efficacy and value, safety, timeliness, patient-centeredness, and equity.
 
WHY THIS MATTERS
 
Approximately one in seven U.S. adults lives with diabetes and it is one of the leading causes of disability, impaired quality of life, and mortality, as well as one of the costliest chronic health conditions for patients and society.
 
Despite the evolution in diabetes care quality measurement in the United States, there has been no commensurate improvement in the health of people with diabetes.
 
The report noted sheer number and disparate types of diabetes quality measures currently in use are a factor in the misalignment of quality measurement and pursuit of high-quality diabetes care and optimal health outcomes.
 
To improve matters, new and modernized measures must be implemented, the report argues, adding there are no existing measures that address and promote equity.
 
In April, CMS outlined a health equity strategy with a focus on access, outcomes, and outreach to better reach those living in underserved populations.
 
THE LARGER TREND
  
Combating diabetes has become an area of increasing focus for healthcare providers-- Geisinger has taken on diabetes reversal through grants, philanthropy and executive buy-in by piloting Fresh Food Farmacy in locations with a population of Type 2 diabetes patients.
 
Type 2 diabetes reversal has also been the focus of a Banner|Aetna partnership with Virta Health on a Type 2 diabetes reversal program.
 
The collaboration gives Banner|Aetna's fully insured and employer group members access to the virtual, provider-led diabetes program.
 
CareFirst BlueCross BlueShield recently awarded $1.76 million to grantees addressing diabetes epidemic, with the funding aimed at organizations working to address the upstream social determinants of health impacting the likelihood of developing diabetes.
 
Earlier this month, California Governor Gavin Newsom said California's state budget would set aside $100 million for the development and manufacture of low-cost insulin products.
 
ON THE RECORD
 
"To improve the quality of diabetes care, the quality measurement framework needs to be reimagined," the report concluded. "Redesigning diabetes care quality measurement and reporting would support practices and policies at all levels of the healthcare system to improve the health of people with diabetes."

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