Table 1.

Measures from the ABIM Diabetes PIM used to Assess Physician Performance

Measure	Performance level
Process measures
Retinal exam	Completed
Nephropathy assessment	Completed
Foot exam	Completed
Smoking status & cessation advice / treatment	Completed
Intermediate outcome measures
A1C poor control	> 9.0%
A1C at goal	< 8.0% or < 7.0% * (based on the patient)
Blood pressure poor control	> = 140/90
Blood pressure superior control	< 130/80
LDL poor control	> = 130 mg/dl
LDL superior control	< 100 mg/dl
Patient experience measures †
Overall diabetes care satisfaction (1 survey question)	Excellent or very good responses
Patient self-care support (7 survey questions combined)	Excellent or very good responses

A1C, Hemoglobin A1C; LDL, Low-density Lipoprotein; ABIM, American Board of Internal Medicine; PIM, Practice Improvement Module.

* The performance level for A1C at Goal is <8.0% for patients aged 65 and over, with coronary heart disease, cerebrovascular disease, peripheral artery disease, or end-stage renal disease, or significant loss of vision or blindness; the level is <7.0% for other patients.

^† Overall diabetes care satisfaction was defined as the percent of patients in a physician’s panel who rated their overall diabetes care "excellent” or “very good" based on one question using a five-point Likert scale. Patient self-care support was defined as the percent of responses per physician that were “excellent” or “very good” across seven questions which included:

-showing understanding of living with diabetes

-encouraging questions and answering them clearly

-providing information on taking medications properly

-providing information on side effects of medications

-teaching foot care

-providing information on proper diabetic diet

-teaching home blood glucose monitoring

Patients who answered “not applicable” or did not answer these questions were excluded from the calculation of this measure.