Stage of Change 2: Assess the Quality of CKD Care in Your Institution
Table of Contents
- Evaluate rates of guideline testing—estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (uACR)—in at-risk patients.
- Use electronic health record (EHR) laboratory data to identify individuals with evidence of CKD but no CKD ICD-10 diagnosis code in their records.
- Request Kidney Health Evaluation for Patients with Diabetes (KED) HEDIS quality measure data from key local payers.
- Use Hierarchical Condition Categories (HCC) coding to evaluate impact of improved CKD coding in value-based care.
- Utilize Area Deprivation Index and American Community Survey data to map ZIP codes in your community that may be disproportionately impacted by health disparities in rates of CKD, diabetes, and/or hypertension.
- References
Assessing CKD care quality can be accomplished according to your institution's needs and with various approaches. Following are available options.
Evaluate rates of guideline testing—estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (uACR)—in at-risk patients.
Resources and Tools:
- NKF, Chronic Kidney Disease Data Analysis Strategy, a concise overview of unrecognized CKD plus data mining parameters via CKDintercept™ Practice Assessment.
Use electronic health record (EHR) laboratory data to identify individuals with evidence of CKD but no CKD ICD-10 diagnosis code in their records.
Resources and Tools:
- NKF, CKDintercept™ Practice Assessment, a concise data analysis strategy inclusive of data mining parameters.
- Sonic Healthcare USA, Chronic Kidney Disease Population Health, overview of CKD assessment utilizing tools and resources available from a national clinical laboratory.
- LabCorp, Diagnostic Assistant, an overview of CKD assessment utilizing tools and resources available from a national clinical laboratory.
Request Kidney Health Evaluation for Patients with Diabetes (KED) HEDIS quality measure data from key local payers.
Resources and Tools:
- National Committee for Quality Assurance (NCQA), Kidney Health Evaluation for Patients with Diabetes HEDIS Measure, a quality measure that assesses whether adults with diabetes 18 years and older receive an annual kidney health evaluation, including estimated glomerular filtration rate (eGFR) and urine albumin-creatinine ratio (uACR).
Use Hierarchical Condition Categories (HCC) coding to evaluate impact of improved CKD coding in value-based care.
Resources and Tools:
- American Academy of Family Physicians (AAFP), Hierarchical Condition Category Coding, describes Centers for Medicare & Medicaid Services (CMS) Hierarchical Condition Category (HCC) Coding and its role in value-based care.
- NKF, SCM23 Abstract, A Retrospective Multisite Examination of Chronic Kidney Disease Using Longitudinal Laboratory Results and Metadata to Inform Value Based Care
Utilize Area Deprivation Index and American Community Survey data to map ZIP codes in your community that may be disproportionately impacted by health disparities in rates of CKD, diabetes, and/or hypertension.
Resources and Tools:
- Centers for Disease Control and Prevention (CDC), Integrating Social Determinants of Health with Treatment and Prevention: A New Tool to Assess Local Area Deprivation, a review of integrating social determinants of health into clinical and preventive care to improve population health and reduce health care disparities.
- U.S. Census Bureau®, American Community Survey Data, updated annually, this "open access" data includes profiles containing social, economic, housing, and demographic data for user-identified geographies.
- Agency for Healthcare Research and Quality (AHRQ), Social Determinants of Health Database, database of social determinants of health at the county, ZIP Code, and tract levels.
- Centers for Medicare and Medicaid (CMS) Data, Mapping Medicare Disparities by Hospital, interactive tool that maps Medicare disparities by social determinants of health, hospital, and patient populations.
The Value of Assessing an Area of Clinical Care and its Impact on an Institution
“The things that are measured and graded are always going to be the things that receive more attention.”
Blake Cameron, MD, MBI
Duke Health, Practicing Nephrologist
Change Package Faculty