SPD: Statin Therapy for Patients With Diabetes
Rate 1: dispensed statin. Rate 2: PDC ≥80%.
Measure description
Rate 1: dispensed statin. Rate 2: PDC ≥80%.
Eligible population
Members with DM
Performance drivers
Star measure; aligned w/ ADA recommendations.
Documentation & PA strategy
Statin in all DM 40-75 unless contraindicated.
Why HEDIS matters for prior authorization
Health plans align prior authorization criteria with HEDIS measures: documenting your patient meets the HEDIS definition often streamlines or eliminates PA hurdles. For Medicare Advantage in particular, plans are heavily incentivized via Star Ratings to push members and providers toward measure compliance, which translates into faster approvals for measure-aligned services.
Frequently asked questions
What does HEDIS measure SPD measure?
Rate 1: dispensed statin. Rate 2: PDC ≥80%.
What drives performance on this measure?
Star measure; aligned w/ ADA recommendations.
How should clinicians document for this measure?
Statin in all DM 40-75 unless contraindicated.
What is the eligible population?
Members with DM
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