Assessing options to increased screening for diabetic retinopathy using education, incentives, or education and incentives in a community health plan

A multi-armed intervention trial to increase diabetic retinopathy screening by a community-based health insurance plan in Central Texas

Status

Active, not recruiting

Phases

Unknown

Study type

Interventional

Source

ISRCTN

Registry ID

ISRCTN87443551

Enrollment

1400

Registered

2019-06-18

Start date

2017-09-19

Completion date

Unknown

Last updated

2020-04-27

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Diabetic Retinopathy Nutritional, Metabolic, Endocrine

Interventions

The purpose of this study was to increase diabetic member uptake of the retinal eye examination in compliance with NCQA HEDIS quality measures. Specifically, we conducted a multi-armed intervention t

(2) a monetary incentive group that received a $25 gift card after completion of the examination

(3) a patient education material only group

and (4) a group that received both patient education material and a $25 gift card after completion of the examination. Sendero members were eligible to participate in this trial if th

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: 1. Insured by Sendero Health Plans in the IdealCare line of business during the calendar year 2017 2. Medical claim for type 2 diabetes or a medication claim used to treat type 2 diabetes mellitus from January 1 through June 30, 2017 3. Live in a household that only had one person diagnosed with type 2 diabetes mellitus

Exclusion criteria

Exclusion criteria: 1. Individuals who had already obtained a retinal eye exam through June 30, 2017 and excluding members who had ongoing, active management for ocular complications associated with type 2 diabetes mellitus.

Design outcomes

Primary

Measure	Time frame
Members who obtained a retinal eye exam from either an ophthalmologist or optometrist were deemed to have completed a retinal eye exam based solely on CPT codes 92004, 92012, and 92014, in accordance with US Centers for Medicare and Medicaid Services Quality Rating System technical specifications. Non-eye care providers must have also provided either a category two CPT code or a HCPCS code to indicate retinal examination occurred (2022F, 2024F, 2026F, and 3072F). Method of Measurement: CPT codes were obtained by SQL query of medical claims processed by Sendero Health Plans, Inc. based on member identification number Timepoint: CPT claims status was obtained based on a date of claim that occurred from September 19, 2017 October 31, 2017 (the study period). Providers have up to 90 days to submit a claim after the date of service. In accordance with end of year activities, we ran the SQL query after March 31, 2018 to account for any claims that occurred during the September 19, 2017 - October 31, 2017 time period.	—

Measure

Time frame

Members who obtained a retinal eye exam from either an ophthalmologist or optometrist were deemed to have completed a retinal eye exam based solely on CPT codes 92004, 92012, and 92014, in accordance with US Centers for Medicare and Medicaid Services Quality Rating System technical specifications. Non-eye care providers must have also provided either a category two CPT code or a HCPCS code to indicate retinal examination occurred (2022F, 2024F, 2026F, and 3072F). Method of Measurement: CPT codes were obtained by SQL query of medical claims processed by Sendero Health Plans, Inc. based on member identification number Timepoint: CPT claims status was obtained based on a date of claim that occurred from September 19, 2017 October 31, 2017 (the study period). Providers have up to 90 days to submit a claim after the date of service. In accordance with end of year activities, we ran the SQL query after March 31, 2018 to account for any claims that occurred during the September 19, 2017 - October 31, 2017 time period.

—

Countries

United States of America

Outcome results

None listed

Source: ISRCTN (via WHO ICTRP) · Data processed: Feb 4, 2026