Hemoglobin A1c Control vs. Glycemic Status Assessment

In case you missed it, the Healthcare Effectiveness Data and Information Set (HEDIS^®) measure Hemoglobin A1c (HbA1c) Control for Patients with Diabetes (HBD) changed to Glycemic Status Assessment for Patients with Diabetes (GSD) in 2024.

What Changed

In addition to compliant HbA1c lab values, GSD allows a compliant glucose management indicator (GMI) value collected by the patient’s continuous glucose monitor (CGM) to satisfy the measure. Glucose management indicator is a calculation derived from a CGM that assesses average blood sugar values. Glycemic metrics from a CGM provide real-time data on individual responses to therapy. This can guide individual diabetes management plans for more timely adjustments and treatment changes. Glycemic status includes both GMI and HbA1c, and can come from any healthcare provider from any setting, including inpatient and at home.

Why This Matters

A GMI uses estimated average glucose (eAG) from a patient’s CGM to approximate an A1c value. Some healthcare providers may find this method more practical as patients don’t have to wait three months for their next A1c test to determine if their care plan is improving blood sugar control. Any member of the care team can document the GMI, including through a nursing outreach or telehealth visit, with no labs needed.

How to Use GMI for the GSD measure

A GMI value can be documented and shared in data in several ways:

1. Document eAG from a CGM in the electronic medical record (EMR) in a structured field.
2. Use the EMR to convert eAG from a CGM into an A1c value. You can find conversion details at the American Diabetes Association.
3. Use the EMR to code for LOINC 97506-0 with the value.

Use These Results

• If the care team documents both a GMI and an HbA1c, or two GMIs, or two HbA1c values on the same date, use the lowest result.
• If GMI is documented as “unknown,” this cannot be used as a result.

Follow These Practices

• Incorporate GMI into workflows and EMR programming to assess blood sugar control for patients who use a CGM. Document the eAG from a patient’s CGM, along with the date range used, and convert this into an HbA1c value.

• • Providers may find this method more practical because patients don’t need to wait three to six months for their next A1c test to see if their care plan is improving blood sugar.
  • Any care team member can record the GMI, including during a nursing outreach or telehealth visit—and no lab work is required.
  • Electronic medical records can be set up to convert eAG into an HbA1c value. Providers can also use the American Diabetes Association’s online calculator to do the conversion.

• Partner with your health plan payers to submit electronic data from your EMR.