Are Your Patients Receiving Their Annual Kidney Health TestS?

Did you know these facts about Chronic Kidney Disease (CKD)?¹

• More than 1 in 7 (14%) adults in the United States have CKD.
• That number increases to 34% for people aged 65 years or older.
• Some 90% of people with CKD do not even know they have it, as people often don’t feel ill or have symptoms.
• Diabetes and high blood pressure are the more common causes of CKD in most adults.
  
  

That’s why annual testing of kidney health is critical for older adults, especially people with diabetes. 

Medicare Advantage plans, including HealthTeam Advantage, are required to report the rate of diabetic members that receive their annual testing through calculation of the Kidney Health Evaluation for Patients with Diabetes (KED) measure. This information is reported to the National Committee for Quality Assurance (NCQA) and Centers for Medicare & Medicaid Services (CMS) annually by plan.² CMS values the importance of this measure to align with recommendations from the American Diabetes Association and provide critical information for screening and monitoring of kidney health for patients with diabetes.³ Thus, starting with this measurement year, CMS made the KED measure 2024 a Star measure! 

To ensure HealthTeam Advantage patients are receiving the necessary services, we are providing education and encouraging members to speak with their providers about getting tested. We need you!

You can identify which of your diabetic patients need these testS by reviewing your monthly Quality Gaps reports. Since more than half of the year is behind us and you have completed most of your Annual Wellness Visits (that’s a topic for another article) or provided many annual screenings, you may be wondering why you still have many patients that are still showing as noncompliant for the KED measure.

We have found that many providers are not testing for both a blood test for kidney function (estimated glomerular filtration rate [eGFR]) and a urine test for kidney damage (urine albumin-creatinine ratio [uACR]).² Hence, the reason the emphasis on the last “s” on “testS”.  

Based on KED data, which includes claims and supplemental data through June 30, 2024:

• Only 37% of HealthTeam Advantage diabetic patients, across both the PPO and HMO plans, have received both eGFR and uACR tests in 2024.
• 48% have received a eGFR test only this year.
• 17% have not received either test.
  
  

Proper and complete testing provide health plans, physicians and patients with the critical information they need to identify chronic kidney disease (CKD) and develop a treatment plan which may include additional testing, lifestyle changes, medicine, and a referral to a nephrologist for further evaluation. The HealthTeam Advantage Quality department wants to encourage providers to put the “s” on “test” and be sure that your patients receive both KED testS.

To learn more about KED and other HEDIS measures, HeathTeam Advantage provides a Provider Reference Guide for your convenience.

1. Centers for Disease Control and Prevention (CDC). 2023. “Chronic Kidney Disease in the United States, 2023.” https://www.cdc.gov/kidney-disease/media/pdfs/CKD-Factsheet-H.pdf
2. National Committee for Quality Assurance (NCQA),2024. “Kidney Health Evaluation for Patients with Diabetes (KED)” https://www.ncqa.org/hedis/measures/kidney-health-evaluation-for-patients-with-diabetes/
3. Centers for Medicare & Medicaid Services, 2021. “Announcement of Calendar Year (CY) 2022 Medicare Advantage (MA) Capitation Rates and Part C and Part D” https://www.cms.gov/files/document/2022-announcement.pdf