Updated Toolkits for Providers: Kidney Health Evaluation and Diabetes Care

Date: February 6, 2025

Attention: All Providers

Updated Toolkits

Texas Children Health Plan (TCHP) would like to inform providers that two of our Healthcare Effectiveness and Data Information Set (HEDIS) Toolkits have been updated: the Kidney Health Evaluation for Patients with Diabetes (KED) and the Diabetes Care (GSD, BPD, EED).

TCHP developed HEDIS Toolkits to share helpful information regarding the measure requirements, standards and codes to use that are acceptable for HEDIS reporting. The toolkits serve as a reference that can be used to correctly code the appointment type and ensure that all of the HEDIS standards are captured and met. This will also help providers maintain a high quality of care for their practice.

We are excited about the benefits these tools will provide for you and the outcomes it will drive for our members. We encourage you to explore the toolkits and begin using them today to enhance your practice. The updated toolkits can be viewed below:

To view additional HEDIS Toolkits, visit: https://www.texaschildrenshealthplan.org/providers/provider-resources/hedis-toolkit

Why it Matters

Diabetes is a chronic condition marked by high blood sugar due to the body’s inability to make or use insulin. Left unmanaged, diabetes can lead to serious complications, including heart disease, stroke, hypertension, blindness, kidney disease, diseases of the nervous system, amputations and premature death. Proper diabetes management is essential to control blood glucose, reduce risks for complications and prolong life.

TCHP encourages providers to continue to take measures with their patients, our members, to address ways they can practice self-care, by taking medications as instructed, eating a healthy diet, being physically active and quitting smoking. Diabetes is the leading cause of chronic kidney disease (CKD) – approximately 1 in 3 adults with diabetes has CKD. CKD happens when an individual’s kidneys are damaged and unable to filter blood as well as usual. As many as 90% of people with CKD do not know they have it, because it often has no symptoms. CKD gets worse over time and can lead to heart disease, stroke and kidney failure. For these reasons, annual monitoring of kidney health is crucial for people with diabetes. Primary detection (kidney health evaluation) and management of kidney disease can prevent these complications and can stop or slow further kidney damage.

Next steps: Providers are encouraged to share this communication with their staff.

Resources:

References:

https://www.ncqa.org/hedis/measures/kidney-health-evaluation-for-patients-with-diabetes/

If you have any questions, please email Provider Relations at: providerrelations@texaschildrens.org.

For access to all provider alerts,log into:
www.texaschildrenshealthplan.org/provideralerts.