Wisconsin Collaborative for Quality Healthcare

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Medical Group
Diabetes: Blood Sugar (A1c) Testing Good glycemic control for people with diabetes is cost-effective and improves quality of life. The A1c test has become the gold standard for assessing and monitoring glycemic control. The American Diabetes Association (ADA) strongly recommends that people with diabetes have two A1c tests annually, at a minimum. This measure assesses the percentage of patients 18 to 75 years of age with a diagnosis of diabetes who had two or more A1c tests, one A1c test, or no A1c tests within the measurement year. This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).Chronic CareMedical GroupEffectiveness
Diabetes: Blood Sugar (A1c) Control In an effort to align with National Quality Forum (NQF) endorsed diabetes measures, and referencing the 2013 American Diabetes Association (ADA) guidelines, the following A1C Control goals for people with diabetes are measured by the WCHQ: Good Control - A1c level controlled to less than 8.0%, Fair to Poor Control - A1c greater than or equal to 8.0% and less than or equal to 9.0%, Uncontrolled - A1c greater than 9.0%, No A1c test within the measurement period This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).Chronic CareMedical GroupEffectiveness
Diabetes: Kidney Function Monitored Diabetes is the leading cause of kidney disease in the United States. Early detection and intervention, along with improved glycemic and blood pressure control, can help reduce the risk of the development and progression of kidney disease. The measure shows the percent of people 18 to 75 years of age with a diagnosis of diabetes who were screened and/or monitored for kidney disease in the measurement year. This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).Chronic CareMedical GroupEffectiveness
Diabetes: Blood Pressure Control Cardiovascular disease is the major cause of mortality for individuals with diabetes. It is also a major contributor to morbidity and direct and indirect costs of diabetes. Studies have shown the benefits of reducing cardiovascular risk factors in preventing or slowing cardiovascular disease. In an effort to align with the National Quality Forum (NQF) endorsed diabetes measures, and referencing the 2013 American Diabetes Association (ADA) guidelines it is recommended that people with diabetes have a blood pressure measured at every routine diabetes visit and that the systolic blood pressure is less than 140 mmHg and the diastolic blood pressure is less than 90 mmHg. This measure assesses the percentage of patients 18-75 whose most recent blood pressure reading within the measurement period is controlled to a rate of less than 140/90 mmHg. This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).Chronic CareMedical GroupEffectiveness
Diabetes: Daily Aspirin or Other Antiplatelet for Diabetes Patients with Ischemic Vascular Disease (IVD) Unless Contraindicated Based on trials involving other secondary prevention therapies, the American College of Cardiology (ACC) and the American Hospital Assocation (AHA) recommends aspirin in all patients, unless contraindicated, with established coronary and other atherosclerotic vascular disease, including peripheral arterial disease, atherosclerotic aortic disease, and carotid artery disease. The ACC and AHA also recommend the use of other antiplatelet agents based on disease type and clinical conditions. The American Diabetes Association (ADA) supports this recommendation as a secondary prevention strategy for type 1 or type 2 diabetes with a history of cardiovascular disease.  This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).Chronic CareMedical GroupEffectiveness
Diabetes: Statin Use Unless Contraindicated In November 2013, The American College of Cardiology/American Heart Association (ACC/AHA) Task Force on Practice Guidelines released updated guidance for the treatment of blood cholesterol. The new recommendations remove treatment targets for LDL-C for the primary or secondary prevention of atherosclerotic cardiovascular disease (ASCVD) and recommend high or moderate intensity statin therapy based on patient risk factors. Four major stain benefit groups were identified and diabetics age 40 to 75 years, regardless of LDL-C level and without clinical ASCVD are one of the identified groups. This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).Chronic CareMedical GroupEffectiveness
Diabetes: Most Recent Tobacco Status is Tobacco-Free Studies of individuals with diabetes consistently demonstrate that smokers have a higher risk of CVD, premature death, and increased rate of microvascular complications of diabetes. Smoking may have a role in the development of type 2 diabetes. The American Diabetes Association (ADA) supports the recommendation to advise all patients not to smoke or use tobacco products and to include smoking cessation counseling and other forms of treatment as a routine component of diabetes care. This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).Chronic CareMedical GroupEffectiveness
Diabetes: All-or-None Process Measure (Optimal Testing) Diabetes All-or-None Measures. The Diabetes All-or-None Measure contains two goals. Both goals within the measure must be reached by each patient in order to meet the measure. Diabetes optimal testing includes: * Two A1C tests performed during the 12 month reporting period AND * One kidney function test during the 12 month reporting period, and/or diagnosis and treatment of kidney disease. Why use an All-or-None method? This method was chosen because of the benefits it provides to both the patient and the provider. For the Patient: The American Diabetes Association recommends these two tests to prevent and reduce diabetes complications such as blindness, loss of limb and kidney disease. Both tests should be performed and the test results will help your doctor decide the best diabetes care for you. The All-or-None measure can be used to see how well diabetes care is done where you receive your care. For the Provider: This method represents a systems perspective emphasizing the importance of optimal care through a patients entire healthcare experience. In addition, this method gives a more sensitive scale for improvement. For those organizations scoring high marks on individual measures, the All-or-None measure will give room for benchmarks and additional improvements to be made. This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).Chronic CareMedical GroupEffectiveness
Diabetes: All-or-None Outcome Measure (Optimal Control)  Diabetes All-or-None Measures. The Diabetes All-or-None Measures are two separate measures, one for process (optimal testing) and one for outcomes (optimal results). Each measure contains three goals. All three goals within a measure must be reached in order to meet that measure. The numerator of each all-or-none measure is collected from the organizations total diabetes denominator. Using the diabetes denominator optimal results includes: * Most recent A1C test result is less than than 8.0% AND * Most recent blood pressure measurement is less than 140/90 mm Hg AND * Tobacco Non-User AND * Daily Aspirin or Other Antiplatelet for Diabetes Patients with Ischemic Vascular Disease Unless Contraindicated AND * Statin Use for patients ages 40 through 75 or patients with IVD of any age. Why use an All-or-None method? This method was chosen because of the benefits it provides to both the patient and the practitioner. First, this methodology more closely reflects the interests and likely desires of the patient. With the data collected in two scores (optimal testing and optimal results), patients can easily look and see how their provider group is performing on these criteria rather than trying to make sense of multiple scores on individual measures. Second, this method represents a systems perspective emphasizing the importance of optimal care through a patients entire healthcare experience. Third, this method gives a more sensitive scale for improvement. For those organizations scoring high marks on individual measures, the All-or-None measure will give room for benchmarks and additional improvements to be made. Nolan T, Berwick DM. All-or-none measurement raises the bar on performance. JAMA. 2006 Mar 8;295(10):1168-70. This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).Chronic CareMedical GroupEffectiveness
CLINIC
Diabetes: Blood Sugar (A1c) Testing Good glycemic control for people with diabetes is cost-effective and improves quality of life. The A1c test has become the gold standard for assessing and monitoring glycemic control. The American Diabetes Association (ADA) strongly recommends that people with diabetes have two A1c tests annually, at a minimum. This measure assesses the percentage of patients 18 to 75 years of age with a diagnosis of diabetes who had two or more A1c tests, one A1c test, or no A1c tests within the measurement year. This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).Chronic Care ClinicEffectiveness
Diabetes: Blood Sugar (A1c) Control In an effort to align with National Quality Forum (NQF) endorsed diabetes measures, and referencing the 2013 American Diabetes Association (ADA) guidelines, the following A1C Control goals for people with diabetes are measured by the WCHQ: Good Control - A1c level controlled to less than 8.0%, Fair to Poor Control - A1c greater than or equal to 8.0% and less than or equal to 9.0%, Uncontrolled - A1c greater than 9.0%, No A1c test within the measurement period This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).Chronic Care ClinicEffectiveness
Diabetes: Kidney Function Monitored Diabetes is the leading cause of kidney disease in the United States. Early detection and intervention, along with improved glycemic and blood pressure control, can help reduce the risk of the development and progression of kidney disease. The measure shows the percent of people 18 to 75 years of age with a diagnosis of diabetes who were screened and/or monitored for kidney disease in the measurement year. This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).Chronic Care ClinicEffectiveness
Diabetes: Blood Pressure Control Cardiovascular disease is the major cause of mortality for individuals with diabetes. It is also a major contributor to morbidity and direct and indirect costs of diabetes. Studies have shown the benefits of reducing cardiovascular risk factors in preventing or slowing cardiovascular disease. In an effort to align with the National Quality Forum (NQF) endorsed diabetes measures, and referencing the 2013 American Diabetes Association (ADA) guidelines it is recommended that people with diabetes have a blood pressure measured at every routine diabetes visit and that the systolic blood pressure is less than 140 mmHg and the diastolic blood pressure is less than 90 mmHg. This measure assesses the percentage of patients 18-75 whose most recent blood pressure reading within the measurement period is controlled to a rate of less than 140/90 mmHg. This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).Chronic Care ClinicEffectiveness
Diabetes: Daily Aspirin or Other Antiplatelet for Diabetes Patients with Ischemic Vascular Disease (IVD) Unless Contraindicated Based on trials involving other secondary prevention therapies, the American College of Cardiology (ACC) and the American Hospital Assocation (AHA) recommends aspirin in all patients, unless contraindicated, with established coronary and other atherosclerotic vascular disease, including peripheral arterial disease, atherosclerotic aortic disease, and carotid artery disease. The ACC and AHA also recommend the use of other antiplatelet agents based on disease type and clinical conditions. The American Diabetes Association (ADA) supports this recommendation as a secondary prevention strategy for type 1 or type 2 diabetes with a history of cardiovascular disease.  This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).Chronic Care ClinicEffectiveness
Diabetes: Statin Use Unless Contraindicated In November 2013, The American College of Cardiology/American Heart Association (ACC/AHA) Task Force on Practice Guidelines released updated guidance for the treatment of blood cholesterol. The new recommendations remove treatment targets for LDL-C for the primary or secondary prevention of atherosclerotic cardiovascular disease (ASCVD) and recommend high or moderate intensity statin therapy based on patient risk factors. Four major stain benefit groups were identified and diabetics age 40 to 75 years, regardless of LDL-C level and without clinical ASCVD are one of the identified groups. This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).Chronic Care ClinicEffectiveness
Diabetes: Most Recent Tobacco Status is Tobacco-Free Studies of individuals with diabetes consistently demonstrate that smokers have a higher risk of CVD, premature death, and increased rate of microvascular complications of diabetes. Smoking may have a role in the development of type 2 diabetes. The American Diabetes Association (ADA) supports the recommendation to advise all patients not to smoke or use tobacco products and to include smoking cessation counseling and other forms of treatment as a routine component of diabetes care. This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).Chronic Care ClinicEffectiveness
Diabetes: All-or-None Process Measure (Optimal Testing) Diabetes All-or-None Measures. The Diabetes All-or-None Measure contains two goals. Both goals within the measure must be reached by each patient in order to meet the measure. Diabetes optimal testing includes: * Two A1C tests performed during the 12 month reporting period AND * One kidney function test during the 12 month reporting period, and/or diagnosis and treatment of kidney disease. Why use an All-or-None method? This method was chosen because of the benefits it provides to both the patient and the provider. For the Patient: The American Diabetes Association recommends these two tests to prevent and reduce diabetes complications such as blindness, loss of limb and kidney disease. Both tests should be performed and the test results will help your doctor decide the best diabetes care for you. The All-or-None measure can be used to see how well diabetes care is done where you receive your care. For the Provider: This method represents a systems perspective emphasizing the importance of optimal care through a patients entire healthcare experience. In addition, this method gives a more sensitive scale for improvement. For those organizations scoring high marks on individual measures, the All-or-None measure will give room for benchmarks and additional improvements to be made. This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).Chronic Care ClinicEffectiveness
Diabetes: All-or-None Outcome Measure (Optimal Control)  Diabetes All-or-None Measures. The Diabetes All-or-None Measures are two separate measures, one for process (optimal testing) and one for outcomes (optimal results). Each measure contains three goals. All three goals within a measure must be reached in order to meet that measure. The numerator of each all-or-none measure is collected from the organizations total diabetes denominator. Using the diabetes denominator optimal results includes: * Most recent A1C test result is less than than 8.0% AND * Most recent blood pressure measurement is less than 140/90 mm Hg AND * Tobacco Non-User AND * Daily Aspirin or Other Antiplatelet for Diabetes Patients with Ischemic Vascular Disease Unless Contraindicated AND * Statin Use for patients ages 40 through 75 or patients with IVD of any age. Why use an All-or-None method? This method was chosen because of the benefits it provides to both the patient and the practitioner. First, this methodology more closely reflects the interests and likely desires of the patient. With the data collected in two scores (optimal testing and optimal results), patients can easily look and see how their provider group is performing on these criteria rather than trying to make sense of multiple scores on individual measures. Second, this method represents a systems perspective emphasizing the importance of optimal care through a patients entire healthcare experience. Third, this method gives a more sensitive scale for improvement. For those organizations scoring high marks on individual measures, the All-or-None measure will give room for benchmarks and additional improvements to be made. Nolan T, Berwick DM. All-or-none measurement raises the bar on performance. JAMA. 2006 Mar 8;295(10):1168-70. This is a measure developed by the Wisconsin Collaborative for Healthcare Quality (WCHQ).Chronic Care ClinicEffectiveness