How to Close Gaps in CKD Screening and Improve HEDIS Measures

Chronic Kidney Disease (CKD) is a significant public health concern that often goes undiagnosed until it reaches an advanced stage. Given its strong link to diabetes, proactive screening and early detection are critical. Health plans and digital health leaders have a unique opportunity to close care gaps and improve patient outcomes, particularly through the Kidney Health Evaluation for Patients with Diabetes (KED) HEDIS measure.

Understanding Chronic Kidney Disease and Its Causes

CKD is a condition where the kidneys are damaged and unable to filter blood effectively, leading to the accumulation of excess waste and fluids in the body. This can cause serious health complications, including heart disease, anemia, bone disease, and, in severe cases, kidney failure requiring dialysis or transplantation.

Diabetes is the leading cause of CKD, followed by high blood pressure. Approximately 35.5 million U.S. adults are estimated to have CKD, yet most remain undiagnosed (CDC). Alarmingly, 40% of individuals with severely reduced kidney function are unaware they have CKD, underscoring the urgent need for better screening efforts (CDC).

The Link Between Diabetes and Chronic Kidney Disease

Diabetes is a major risk factor for CKD, with 1 in 3 adults with diabetes also having CKD (CDC). Both type 1 and type 2 diabetes can contribute to kidney disease by damaging blood vessels in the kidneys.

Each kidney contains millions of tiny filters called nephrons. Over time, high blood sugar from diabetes can harm these nephrons and the blood vessels in the kidneys, impairing their ability to filter waste effectively. Additionally, many people with diabetes develop high blood pressure, which further damages kidney function.

CKD often progresses silently, with no noticeable symptoms in its early stages. Without regular screening, many individuals are unaware of their condition until it reaches an advanced stage, requiring dialysis or a kidney transplant. That’s why regular kidney function testing is crucial for people with diabetes—early detection allows for intervention that can slow disease progression and prevent complications.

To maintain kidney health, people with diabetes should focus on managing blood sugar, blood pressure, and cholesterol levels, following a kidney-friendly diet, and staying physically active.

The Importance of the HEDIS KED Measure

To address the widespread underdiagnosis of CKD, the Kidney Health Evaluation for Patients with Diabetes (KED) measure was introduced as part of the HEDIS (Healthcare Effectiveness Data and Information Set) performance improvement tool. Developed by the National Committee for Quality Assurance (NCQA) and the National Kidney Foundation (NKF), this measure aims to improve kidney health evaluation rates for patients with diabetes (NCQA).

The KED measure assesses the percentage of adults (ages 18–85) with diabetes who receive an annual kidney health evaluation, which includes:

• Estimated glomerular filtration rate (eGFR) – Measures kidney function.
• Urine albumin-creatinine ratio (uACR) – Detects kidney damage.

Despite clinical guidelines recommending regular kidney disease screening for people with diabetes, fewer than 50% of eligible patients receive both tests (NCQA). The implementation of the KED measure provides healthcare leaders with a clear opportunity to track and enhance kidney disease testing efforts.

Why Regular Screening Matters

Kidney disease is known as a "silent disease" because symptoms often do not appear until the condition is severe. Early detection through routine screening allows for timely interventions, including lifestyle changes, medications, and specialist referrals that can slow disease progression.

Additionally, kidney disease has substantial economic implications. In 2019, the treatment of Medicare beneficiaries with CKD cost $87.2 billion, while care for individuals with end-stage kidney disease cost an additional $37.3 billion (CDC). By prioritizing CKD screening, health plans can help reduce long-term healthcare costs and improve patient quality of life.

How At-Home Health Solutions Help Meet the HEDIS KED Measure

Traditional in-clinic testing can be a barrier for many patients due to logistical challenges, lack of awareness, or limited access to healthcare facilities. At-home health solutions offer a convenient, patient-centered approach to overcoming these obstacles.

Ash enables health plans to close care gaps by providing at-homescreening services, including uACR, eGFR, and creatinine tests for kidney health. With at-home health solutions, patients can receive the necessary kidney function evaluations without having to visit a lab or clinic. This approach increases adherence to screening recommendations, enhances early detection, and helps health plans improve their performance on HEDIS measures like KED.

Final Thoughts

Addressing chronic diseases requires a proactive, data-driven approach. The HEDIS KED measure provides health plans with a clear metric to improve kidney health outcomes among patients with diabetes. By incorporating at-home health solutions, healthcare organizations can remove barriers to care, increase screening rates, and ultimately improve early detection and treatment of CKD.

To learn more about how Ash can support your health plan in closing care gaps, contact us here.

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