Provider Insider

Clinical Transformation Insights

Winter 2018 | Issue No. 4

Diabetes is a disease and left untreated can lead to serious complications. Proper diabetes management includes controlled blood glucose to thus reduce complications and prolong life. Not surprisingly, all of Coordinated Care’s value-based contracts include at least one quality metric associated with diabetes.


The National Committee for Quality Assurance (NCQA) is an independent organization that works to improve health care quality through the administration of evidence-based standards and considers comprehensive diabetes care to include hemoglobin A1c (HbA1c) greater than 8 percent controlled. The network’s clinical committee sanctioned this standard of care last summer, and a team of technical analysts has been working to build a measure in Epic to track performance. The measure is now live within Epic’s Primary Care Quality Dashboard and the Power BI reporting tool. Current performance is displayed below.

Epic clinical data only, claims data is excluded. Patients 18-75 years of age with diabetes Type 1 and Type 2 who had an HbA1c < 8% in the past 12 months.


Prioritizing diabetes care management.

Several network partners have implemented clinical care delivery models to improve the care of their diabetic patients:

  • UCHealth Medical Group implemented an improved clinical pathway for their diabetic patients.
  • Associates in Family Medicine implemented a pre-charting process for diabetic patients and enhanced their rooming workflow for optimal care.
  • UCHealth Family Medicine Center – Fort Collins piloted diabetes-specific clinic appointments and increased appointment slots from 20 minutes to 40 minutes.

Time will tell how significant an impact the network’s enhanced clinical pathways will have on the population. In the meantime, we encourage you to use this mechanism to track performance. The newly implemented HbA1c measure, along with other diabetes quality measures being tracked (e.g., Diabetes Nephropathy Screening, Diabetes Statin Compliance Rate and Diabetes Hypertension), provide a comprehensive look at the health of the diabetic patient population.


For more information, please contact [email protected].