SPD: Statin Therapy for Patients with Diabetes (SUPD below)
Product Line: Medicaid, Medicare, Marketplace

Statin Therapy for Patients with Diabetes is a HEDIS measure that focuses on patients and their adherence to at least one statin medication of any intensity during the measurement year.

Service Needed

Patients 40 to 75 years of age with diagnosis of diabetes who do not have diagnosis of clinical atherosclerotic cardiovascular

disease (ASCVD) and being treated with and remain taking at least one statin medication of any intensity.

Two rates reported for this measure are:

1. The percentage of patients who are dispensed at least one statin medication of any intensity during the measurement year.
2. Percentage of patients who remain on a statin medication of any intensity for at least 80 percent of the treatment period.

Tips for Attainment:

• At each visit, review the medication list and ask if there are any issues with filling or taking medications as prescribed. If there are any problems/issues with the medication, open-ended questions will assist you with solutions and remove patient barriers to adherence.
• Assess health literacy to determine need for additional support in medication management.
• Educate members on the purpose of taking a statin medication to prevent cardiovascular disease. Discuss how often to take the medication and possible side effects.
• Advise member to contact provider's office if side effects occur or are suspected. Consider an alternative dosing schedule to prevent or lessen side effects.
• Offer 100-day supply of medication to members, if stable.
• Encourage member to sign up for mail orders at their retail or mail-order pharmacy.
• Reminder calls, emails, text messages or mailings can assist with ensuring members do not miss scheduled appointments.
• Schedule an annual visit or follow-up visit before the member leaves the office.
• Ensure member completes any required labs such as cholesterol, kidney values (both blood and urine) and/or A1c.

Buckeye Initiatives: 

Weekly Outreach

1. Data analytics team generates weekly report identifying BHP members with diagnosis of Diabetes and do not have a diagnosis of ASCVD and no record of statin therapy
2. Pharmacy team makes up to 2 fax attempts to each provider for each identified member to request provider to evaluate if statin therapy is appropriate for member
3. No response from fax outreach, then Buckeye clinical pharmacist (when appropriate) attempts to contact provider to review and resolve the opportunity.
4. For members currently taking statin therapy but fall below 80% adherence – fax outreach is made to provider to alert them that member is non-adherent to their statin therapy.

SUPD: Statin Use in Persons with Diabetes
Product Line: Medicare

Statin Use in Persons with Diabetes is a Medicare measure that is defined as the percent of Medicare Part D beneficiaries ages 40 to 75 who were dispensed at least two diabetes medication fills on unique days of service and received a statin medication fill during the measurement period.

Service Needed

Patients 40 to 75 years of age with diagnosis of diabetes being treated with and remain taking at least one statin medication of any intensity.

The rate reported for this measure is:

The percentage of Medicare Part D beneficiaries ages 40 to 75 who were dispensed at least two diabetes medication fills on unique days of service and received a statin medication fill during the measurement period.

Tips for Attainment:

• At each visit, review the medication list and ask if there are any issues with filling or taking medications as prescribed. If there are any problems/issues with the medication, open-ended questions will assist you with solutions and remove patient barriers to adherence.
• Assess health literacy to determine need for additional support in medication management.
• Educate members on the purpose of taking a statin medication to prevent cardiovascular disease. Discuss how often to take the medication and possible side effects.
• Advise member to contact provider's office if side effects occur or are suspected. Consider an alternative dosing schedule to prevent or lessen side effects.
• Offer 100-day supply of medication to members, if stable.
• Encourage member to sign up for mail orders at their retail or mail-order pharmacy.
• Reminder calls, emails, text messages or mailings can assist with ensuring members do not miss scheduled appointments.
• Schedule an annual visit or follow-up visit before the member leaves the office.
• Ensure member completes any required labs such as cholesterol, kidney values (both blood and urine) and/or A1c.

Diabetes is an epidemic in the United States. According to the Centers for Disease Control and Prevention (CDC), over 38 million Americans have diabetes and face its devastating consequences. What’s true nationwide is also true in Ohio. Obesity is linked to up to 53 percent of new cases of type 2 diabetes each year. Treating the chronic disease of obesity can help prevent, delay, and even result in diabetes remission. See the great information provided by the AMA below.

AMA - The Burden of Diabetes in Ohio

 

For more information, exclusions and improvement tips see our HEDIS Reference Guide (PDF).