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Hemoglobin A1c Control

According to the American Diabetes Association, the A1c blood test will advise your patients on how their treatment plan is working by giving them a picture of their average blood glucose (blood sugar) over the past two to three months. It’s a critical tool used in forming a game plan between you and your patient for managing their care.

Measure Compliance

The percentage of patients between 18-75 years of age with diabetes (types 1 and 2), whose hemoglobin A1c (HbA1c) was at the following levels during the measurement year:

  • HbA1c control (≤9.0%)
  • HbA1c poor control (>9.0%)

Measure Tips

  • Documentation must include screening results and date of service in patient’s progress note.
  • Telehealth is not sufficient to complete screening, but documentation in telehealth visit of prior screening will count for compliance. Collect and document history of diabetes care.
  • The most recent result is the ONLY result used to determine compliance.

Measure Codes

  • 3044F: < 7%
  • 3046F: > 9%
  • 3051F: ≥ 7% and < 8%
  • 3052F: ≥ 8% and ≤ 9%

Measure Exclusions

  • Patients receiving hospice or palliative care during measurement year.
  • Patients with a diagnosis of polycystic ovarian syndrome, gestational diabetes or steroid-induced diabetes.

Best Practices

Order 90-day prescription or home delivery program to ensure compliance. To manage blood glucose, emphasize the importance of medication and insulin adherence.

Schedule follow-up visits early in the year and regularly throughout (3 – 4x total) to monitor
results, adjusting therapies to improve levels.

Monitor whether patients are up-to-date with recommended screenings.

Assist patients in enrolling in mail order and auto-refill.

Reinforce with patients to take their medication at the same time each day to help regulate
their blood sugar levels.

Encourage patients to follow a healthy diet and exercise regularly. Refer them to the nutritionist and clinical diabetes educator for additional support.

The American Diabetes Association recommends that blood sugar targets should be individualized. Encourage patients with type 2 diabetes to discuss their goals with their doctor and diabetes educator.

HealthCare Partners (HCP) is here to help!

HCP Pharmacy Staff
Call: (516) 515–8861
Monday through Friday, 8:30am – 5:30pm EST

HCP Case Managers
Call: (888) 258–0203
Monday through Friday, 8:30am – 5:30pm EST
Our Case Managers can:

  • Teach patients about their condition.
  • Guide them in making a treatment plan.
  • Help them get medications and care.
  • Coordinate transportation based on member’s assigned benefit.
  • Set up referrals and doctor visits.
  • Provide a Nurse on call, 24/7 at (516) 238-6124.

Download Hemoglobin A1c Control for Patients with Diabetes (HBD)