CMS Now Requires Quarterly HbA1c for Patients with Type II Diabetes

a1cThe Centers for Medicare & Medicaid Services (CMS) have new, required care elements for patients with type 2 diabetes mellitus.1 The local coverage determination applies to sixteen states including Texas, and it took effect earlier this year. All home health plans of care for patients with type 2 diabetes must include HbA1c level monitoring at least quarterly, and such plans of care must also include intermittent capillary blood/serum glucose level monitoring. Aspen Healthcare is aware of the new requirements and will help doctors make sure all plans of care are in compliance with all Medicare regulations. Top points from the new local coverage determination include:

  • Required for all type 2 diabetic patients, regardless of insulin therapy status
  • If the home health plan of care is for therapy only, monitoring is still required
  • If HbA1c levels are not available at the home health start of care, there must be orders to get HbA1c levels at the time of admission
  • Medicare pays for HbA1c levels every 90 days, so Medicare is actually looking for HbA1c levels every 90 to 120 days.

The CDC reports that 12.6% of adults with diabetes exhibit poor glycemic control.2 CDC researchers state that the majority of adults with diabetes would benefit from reduction of A1c levels to ≤ 7%, and that an A1c level of 9% represents a modifiable, high level of risk that warrants additional intervention. When glycemic control is poor (A1c > 9%), diabetes levies additional healthcare costs, higher risk of hospitalization / re-hospitalization, and high risk of disabling complications. Poor glycemic control creates higher risk of diabetic retinopathy, chronic kidney disease, and cardiovascular disease. 3-5 When you have homebound patients exhibiting poor glycemic control, please consider Aspen Healthcare as a strong ally in your diabetes management plan. For your homebound patients, Aspen Healthcare can provide a number of services designed to improve your patients’ diabetes management.

Observation & Assessment: In situations where blood glucose levels or blood pressures begin fluctuating abnormally, it may be appropriate for doctors to order a home health episode. Nurses can investigate adherence to special diets and reinforce teaching. They can monitor blood pressure levels and report to the physician for medication changes. They can assess the use of home equipment and make necessary changes. Nurses can also teach diet and exercise intervention to better control fluctuating glucose levels.

Patient & Family Education: Effectively teaching geriatric patients sometimes requires repeated visits and a significant time investment. You can trust Aspen Healthcare to work diligently until your patients demonstrate the skills and knowledge necessary to manage their diabetes. Teaching will include:

  • Preparing & administering insulin injections
  • Glucose monitoring
  • Preparing & following a diabetic diet Observation of foot care precautions
  • Exercise intervention to control fluctuating glucose levels
  • Observation & understanding s/s of hyper/hypoglycemia
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