Diabetes Monitoring for People with Diabetes and Schizophrenia (SMD)

What is the SMC — HEDIS® Measure?

Based on current HEDIS recommendations for best practices, this measure examines the percentage of members 18–64 years of age with schizophrenia or schizoaffective disorder and diabetes who had both an LDL-C test and an HbA1c test during the measurement year.

The following will meet compliance:

An HbA1c performed during the measurement year (on the same or different dates of service). The member must have both tests to be included the numerator.

LDL-C test and an HbA1c: Documentation in the medical record must include a note indicating both an LDL-C test and an HbA1C test were performed during the measurement year.

NCQA HEDIS Population Definition for This Measure:

Population: Members who are 18-64 years of age as of December 31 of the measurement year who had a diagnosis schizophrenia or schizoaffective disorder and diabetes who had both an LDL-C test and an HbA1c test during the measurement year.

Line of Business: Medicaid

Reference: Diabetes Monitoring for People with Diabetes and Schizophrenia (SMD), NCQA HEDIS Tech Specifications

Best Practices

Order screening tests every year and build care gap “alerts” in your electronic medical record
Follow up with patients to discuss and educate on lab results
Coordinate care with patients’ other providers
Outreach patients who have not had their labs done and ask them to complete as soon as possible
Encourage shared decision-making by educating patients and caregivers about increased risk of diabetes
Discuss with member the Importance of screening for diabetes
Educate the member on symptoms of new-onset diabetes

To learn more about your practice's current HEDIS performance, HEDIS Value sets for this or other measures, or for assistance in compliance with the HEDIS guidelines, please email BH_HEDISTeam@HorizonBlue.com or visit Provider Tips for Optimizing HEDIS Results Booklet.