Abstract: SA-PO0450
Early Effect of a Statewide Nephrology-Primary Care Collaborative to Improve Albuminuria Screening in Patients with Type 2 Diabetes
Session Information
- CKM: Clinical - Screening, Population Management, Care Disparities, and Patient-Centered Outcomes
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Cardiovascular-Kidney-Metabolic Health
- 602 Cardiovascular-Kidney-Metabolic Health: Clinical
Authors
- Wright Nunes, Julie A., University of Michigan Michigan Medicine, Ann Arbor, Michigan, United States
- Rau, Jacqueline, University of Michigan Michigan Medicine, Ann Arbor, Michigan, United States
- Saran, Rajiv, University of Michigan Michigan Medicine, Ann Arbor, Michigan, United States
- Reiss, Jacob E., University of Michigan Michigan Medicine, Ann Arbor, Michigan, United States
- Heung, Michael, University of Michigan Michigan Medicine, Ann Arbor, Michigan, United States
Background
Albuminuria screening is essential for chronic kidney disease detection in type 2 diabetes (T2D) but remains suboptimal. The Blue Cross Blue Shield of Michigan Collaborative for Type 2 Diabetes (MCT2D) is a statewide quality improvement program that includes a nephrology arm, the Michigan Kidney Improvement Collaborative (MKIC). The initiative focuses on practices caring for BCBS, BCN, and Medicare Advantage patients. This year's focus is urine albumin-to-creatinine ratio (uACR) screening, aligned with HEDIS Kidney Evaluation measures.
Methods
We used claims and clinical data from the Collaborative Quality Initiative Population Health Registry to develop and implement a uACR screening metric across primary care and nephrology practices. Eligible patients included adults aged 18–85 years with T2D. We defined baseline (01/01/2024–02/28/2025) and performance assessment (07/01/2025–08/31/2026) periods. Fourteen-month intervals ensured capture of claims within or near a one-year period. Practice-level uACR completion rates were calculated, and improvement targets were set (≥5% absolute increase for nephrology; ≥10% for primary care). Interventions included performance feedback, an interactive dashboard, quarterly reports on practice progress and best practices, clinician/patient educational materials, and practice facilitation in partnership with the National Kidney Foundation of Michigan. Practices achieving targets will receive value-based reimbursements.
Results
Across 14 nephrology and 339 primary care practices, mean (SD) baseline uACR completion was 67.1% (11.7%) and 72.3% (13.9%), respectively. At interim analysis through the midpoint assessment date of 01/31/2026, 12 of 14 (86%) nephrology practices and 44 of 339 (13%) primary care practices were on track to meet improvement targets. Final performance assessment will occur 08/31/2026.
Conclusion
A statewide collaborative using registry-based measurement, regular feedback, and targeted practice support is feasible and shows early success in nephrology practices, with more limited uptake in primary care. These findings highlight opportunities and challenges to optimize implementation strategies and improve albuminuria screening at scale, including expansion to Medicaid populations. Registry data procurement, practice engagement, and implementation of workflow changes were identified as challenges.
Funding
- Commercial Support – BCBS Michigan Collaborative