Diabetes is the leading cause of kidney disease and accounts for about 44% of new cases [1]. Type 1 and type 2 diabetes can cause kidney disease, and approximately one in three adults with diabetes have chronic kidney disease (CKD) [2].

At its onset, Chronic Kidney Disease (CKD) is asymptomatic, and only routine screening can identify it in its earliest stages. Even among at-risk populations, such as those with diabetes, CKD often goes undetected until its later stages.

The Kidney Health Evaluation for Patients with Diabetes (KED) HEDIS measure was developed with the goal of improving the rate of testing for CKD among people with diabetes. Here’s more about this HEDIS measure and how at-home healthcare solutions can help plans meet this quality measure.

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About Kidney Health Evaluation for Patients with Diabetes (KED) HEDIS measure

In 2020, the National Committee for Quality Assurance (NCQA) and the Centers for Medicare & Medicaid Services (CMS) introduced a HEDIS measure to improve kidney health in the United States.

The Kidney Health Evaluation for Patients with Diabetes (KED) measure replaced the previous Screening for Nephropathy measure, aiming to close gaps in care and provide increased focus on the kidney health of diabetic populations.

The KED measure tracks the percentage of adults with diabetes between 18 and 85 who have received an annual kidney health evaluation using the estimated glomerular filtration rate (eGFR) and urine albumin-creatinine ratio (uACR) [3].

How diabetes can lead to chronic kidney disease

Each kidney consists of millions of tiny filters called nephrons. Over time, high blood sugar from diabetes can damage blood vessels in the kidneys as well as nephrons, so they don’t work as well as they should.

Many people with diabetes also develop high blood pressure, which can damage the kidneys and lead to kidney disease. Individuals with diabetes can also develop hypertension or high blood pressure, which can damage the kidneys.

About chronic kidney disease (CKD)

Chronic kidney disease, also called chronic kidney failure, involves a gradual loss of kidney function over time. The kidneys filter wastes and excess fluids from blood, which are removed through urine. When chronic kidney disease advances, it can cause dangerous levels of fluid, electrolytes, and wastes to build up in the body.

There are few signs and symptoms in the early stages of chronic kidney disease, so many do not realize they have kidney disease until the condition is advanced. Chronic kidney disease is a disease multiplier, significantly increasing one’s risk for cardiovascular events and mortality. Annual screening, early recognition, and diagnosis can slow progression and reduce rising cardiovascular risk.

The importance of regular kidney health evaluation screening

While screening is integral to improving outcomes, it isn’t happening among people at risk for kidney disease. An estimated 37 million Americans have CKD, but only 10 percent or fewer than 4 million know it [4]. Additionally, among people with diabetes, 61 percent are not receiving the recommended testing [5].

As kidneys do not signal problems until they are near failure, routine health and performance measurement is crucial to determining if kidney damage is present. Those with diabetes should regularly have their kidneys checked as it is the best chance for identifying CKD early.

Kidney damage caused by diabetes usually happens slowly, so early detection can help prevent or delay further damage. Early treatment is most effective and can help prevent additional health problems.

How meeting the KED HEDIS measure can impact Star ratings

Closing gaps in CKD screening can help health plans meet the KED HEDIS measure and improve their Star rating. Higher Star ratings are key to attracting new enrollees and expanding market share, which can translate into additional bonus payments and greater rebates.

A 1-star rating improvement could, on average, lead to a year-over-year 8% to 12% increase in plan enrollment, while improving from a 3-star to 4-star rating could increase revenue between 13.4% and 17.6% through increased enrollment revenue and additional bonus payments [6].

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How LetsGetChecked can help plans meet the KED HEDIS measure

Engaging members in kidney health screening can be challenging as barriers to access still exist. Members may experience difficulties taking time off work and accessing transportation, healthcare providers, and facilities.

LetsGetChecked’s digital engagement solutions and home-based health testing programs can give members a quick and convenient way to stay up-to-date on recommended screenings and manage existing conditions.

With our at-home healthcare solutions, health plans can provide quality care that impacts Star ratings and HEDIS measures to improve member retention, satisfaction, and expansion. Our solutions can help members easily engage in the care they need, driving down medical expenses and enabling better health outcomes.

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  1. https://www.kidney.org/news/newsroom/factsheets/Diabetes-And-CKD
  2. https://www.cdc.gov/diabetes/managing/diabetes-kidney-disease.html
  3. https://www.ncqa.org/hedis/measures/kidney-health-evaluation-for-patients-with-diabetes/
  4. https://www.kidney.org/news/newsroom/fsindex
  5. https://www.kidney.org/atoz/content/chronic-kidney-disease-quality-care-begins-measurement
  6. https://guidehouse.com/-/media/www/site/insights/healthcare/2018/medicare-advantage-analysis.pdf