CommercialDocumentationMedium impact
Quality measure refresh – Diabetes
Blue Cross Blue Shield of Rhode Island·RI · Family Medicine, Internal Medicine, Endocrinology·Physician
Effective date
Nov 1, 2024
We identified it
Jun 19, 2026
Summary
BCBSRI updated their Quality P provider incentive program with refreshed diabetes screening requirements for 2024. The policy outlines three HEDIS quality measures that practices should focus on: glycemic status assessment (HbA1c targets), kidney health evaluation (eGFR and urine albumin-creatinine ratio), and retinal eye exams for diabetic patients.
Action Required
Immediately: Providers should implement EMR order sets or workflows to ensure diabetic patients receive all three required screenings: HbA1c testing (target <8.0% commercial, <9.0% Medicare), kidney evaluation with both eGFR and urine albumin-creatinine ratio, and annual retinal eye exams. Billing team should ensure proper coding for eGFR and uACR tests per the 2024 PCP Quality Incentive Program booklet. Contact QualityHEDIS@bcbsri.org for coding guidance to avoid missing quality measure opportunities.