Provider Insider

Payer Feedback

Spring 2022 | Issue No. 13

Diabetes care quality measures play a significant role in all of our payer contracts, which is why four of the six metrics on our 2022 Single Scorecard involve the care of patients with diabetes. Success in these metrics will not only lead to better outcomes for our diabetic patients; it will also generate financial success in our value-based contracts.

So, how are we doing according to the payers? The Medicare Advantage data probably tells the story best: We have some work to do, most significantly in the area of diabetes, blood sugar controlled (A1c <8).

Diabetes Care Quality Measures

Medicare Advantage Programs: Star Ratings

Across our Medicare Advantage programs, C3 performance is only at a 2-star rating for diabetes control. This is below the threshold needed to earn incentives in this metric. Since this is a triple-weighted measure in the MA space, this performance is heavily impacting our overall star ratings so we will continue to focus on this measure throughout the year.

Notes:

  • Anthem MA and Humana MA reporting through October 2021; Cigna MA and United MA reporting through November 2021.
  • Despite having 4 stars in A1c Control in Humana MA, we are not meeting the minimum target for the model practice quality incentive program.
  • Payer-specific measures may not always be identical to Single Scorecard measures.font