Closing the KED Gap: Maximize HEDIS Measure Performance with At-Home Lab Test Kits

Diabetes is currently the leading cause of chronic kidney disease (CKD), with approximately 1/3 of all adult diabetics suffering from CKD. Often due to the lack of physical symptoms, up to 90% of those individuals living with CKD have no knowledge of its presence or effect on their health until it’s at an advanced stage.¹

Given the prevalence and downstream health complications stemming from kidney disease, both CMS & NCQA recommend prioritizing early disease detection through the Kidney Health Evaluation for Patients with Diabetes (KED) HEDIS measure.

Using clinical practice guidelines from the American Diabetes Association and the National Kidney Foundation, all diabetic patients should be screened annually using an estimated glomerular filtration rate (eGFR) and a urine albumin-to-creatinine ration (uACR) test.²

For health plan members to successfully close the KED measure for HEDIS performance reporting purposes, NCQA requires both tests to be completed within the same measurement year. By incorporating these two tests for KED, health plans and their diabetic members can better understand changes in kidney health over time while creating a managed care plan to improve long-term health outcomes.

Mind the Gap: Improving KED Measure Compliance

The KED measure looks at the percentage of members 18-85years of age with diabetes (both type 1 & type 2) who received a kidney health evaluation, defined by an eGFR and uACR test during the measurement year. These quantitative blood and urine tests are meant to be used in combination with each other to effectively diagnose CKD while scoring a member's risk level.³

While guidelines consider semi-quantitative urine tests completed either at-home or in a point-of-care setting useful, the expectation is that they will ultimately be confirmed by a quantitative urine test performed by an accredited lab facility. Due to these guidelines, the quality measure specification only includes confirmed quantitative test results, since any semi-quantitative test alone would not be considered adequate for evaluating and managing kidney disease.⁴

• Quantitative: These test results are reported as a numeric value and are used in combination with a blood test to diagnose CKD while monitoring disease progression.
• Semi-Quantitative: These test results are reported in categories or ranges and are often less precise but provide a level of convenience due to their ability to be completed quickly within a home-based setting.

Health plans should avoid relying solely on their in-network primary care providers to help close the KED gap since this approach could hinder the ability to maximize Star Ratings performance. Through at-home KED testing, Retina Labs enables health plans to target this measure by encouraging their members to self-complete the test on their own, helping drive member participation and gap closure rates.

At-Home KED Lab Testing for Health Plan Members

Retina Labs at-home lab testing offers a comprehensive solution for closing the HEDIS measure targeting Kidney Health Evaluation in Patients with Diabetes (KED) by mailing our high-quality test collection kits directly to your members. Thanks to our easy-to-follow directions for self-completion included within each kit, members can send their blood and urine samples using pre-paid return shipping labels to our CLIA &CAP-accredited lab facility for resulting. Once received, our accredited lab facility will deliver reliable and accurate eGFR & uACR test results for both members and their PCPs to review respectively.

Beyond KED testing, Retina Labs also provides members with the opportunity to close additional HEDIS gaps in care measures from the comforts of home through our HbA1c and Colorectal Cancer (FIT) test kits. This inclusive approach to at-home lab testing helps eliminate traditional access to care barriers for members who historically encounter various availability, transportation, and mobility limitations.

By focusing on improving health outcomes through early disease detection, Retina Labs direct-to-member at-home lab test kit programs provide health plans with the resources necessary to drive higher member participation rates to ensure multiple HEDIS gaps in care measures are closed in a timely manner.

Direct-to-Member At-Home Lab Testing Program Features

• Co-branded test kits specific to your health plan
• Member opt-in management process
• Turn-key test kit fulfillment with pre-paid return shipping labels
• Member reminder communications & dedicated telephonic support
• Lab analysis & physician authorization integrations
• Timely test result communications to both members & their PCPs
• Critical result alert value outreach for all participating members
• Real-time program insights & supplemental data via ComplyHub platform
• Volume-based test kit pricing with pay-for-performance model (no minimums)

Learn more about Retina Labs Direct-to-Member At-Home Lab Testing program by visiting the link to our brochure below:

Direct-to-Member At-Home Lab Testing Brochure (PDF)

Looking for a KED Star Ratings Evaluation?

We’re here to help! Contact us today to learn more about our comprehensive approach to at-home lab testing to close the KED care gap and drive HEDIS measure performance improvement that can boost your current Star Ratings.

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References:

1. Kidney Health Evaluation for Patients with Diabetes (KED) | NCQA
2. Kidney Health Evaluation for Patients with Diabetes (KED) Flyer | Humana
3. Update on Kidney Health Evaluation for Patients With Diabetes (KED) Measure Specification: Conformant Tests | NCQA
4. Update on Kidney Health Evaluation for Patients With Diabetes (KED) Measure Specification: Conformant Tests | NCQA

Infographic/Table References:

Kidney Disease Fact Sheet | National Kidney Foundation
Kidney Health Evaluation for Patients with Diabetes (KED) Flyer | Humana
Update on Kidney Health Evaluation for Patients With Diabetes (KED) Measure Specification: Conformant Tests | NCQA