title: A Historical Retrospective Analysis of the Impact of Diabetes Quality Measure Attainment on Outcomes in Medicare Advantage Members.
abstract: The objective of this study was to assess achievement of 4 diabetes mellitus (DM)-related quality measures (QMs) and examine the relationship between QM attainment, concurrent health care costs, and DM complications over 1 year by conducting a retrospective analysis of claims data for Medicare Advantage Prescription Drug plan members with DM. Claims and member-level quality data were used to assess QM achievement, concurrent health care costs, and presence of new or worsening DM complications during the QM year. Multivariable regression models were used to examine the relationship between QM achievement and outcome measures controlling for potentially confounding baseline characteristics. QM attainment rates ranged from 54.2% for DM Treatment measure to 83.4% for Cholesterol Screening measure. Odds of new or worsening complications were greater for members who did not meet the Blood Sugar Controlled performance goal (odds ratio [OR]: 1.12, P < 0.001), DM Treatment goal (OR: 1.40, P < 0.001), or Cholesterol Screening goal (OR: 1.32, P < 0.001). Failure to attain the DM Medication Adherence goal was associated with lower odds of new or worsening complications (OR: 0.94, P < 0.001). In the regression models, all-cause health care costs were greater for members who achieved the Blood Sugar Controlled quality goal (P < 0.001), but lower for members who attained DM Treatment (P < 0.001) and low-density lipoprotein Cholesterol Screening goals (P < 0.001). There was no statistically significant relationship between attaining the DM Medication Adherence measure and all-cause costs. Achievement rates for individual QMs varied across the study population and relationships between QM attainment, health care costs, and DM complications during the QM measurement year were mixed.
authors.affiliation: 1 Comprehensive Health Insights, Inc. , Louisville, Kentucky.
authors.forename: Vishal
authors.initials: V
authors.lastname: Saundankar
authors.affiliation: 1 Comprehensive Health Insights, Inc. , Louisville, Kentucky.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Ellis
authors.affiliation: 1 Comprehensive Health Insights, Inc. , Louisville, Kentucky.
authors.forename: Chad
authors.initials: C
authors.lastname: Moretz
authors.affiliation: 2 Humana Inc. , Louisville, Kentucky.
authors.forename: Yunus
authors.initials: Y
authors.lastname: Meah
authors.affiliation: 3 Novo Nordisk Pharmaceuticals, Inc. , Plainsboro, New Jersey.
authors.forename: Tony
authors.initials: T
authors.lastname: DeLuzio
authors.affiliation: 3 Novo Nordisk Pharmaceuticals, Inc. , Plainsboro, New Jersey.
authors.forename: Elsie
authors.initials: E
authors.lastname: Allen
authors.affiliation: 1 Comprehensive Health Insights, Inc. , Louisville, Kentucky.
authors.forename: Brandon T
authors.initials: BT
authors.lastname: Suehs
authors.affiliation: 3 Novo Nordisk Pharmaceuticals, Inc. , Plainsboro, New Jersey.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Bouchard
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D020398:Medicare Part C; D008875:Middle Aged; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D055815:Young Adult