• Pre-post intervention change in HbA1c level
  

• Pre-post intervention change in other patient outcomes; Performance of diabetes related processes of care
  

HealthTexas Provider Network primary care practices with at least 10 Medicare diabetes patients over the age of 65 were randomized to one of 3 intervention arms: physician feedback of process measures using Medicare claims data (“Claims”); feedback of Medicare claims data plus clinical measures from medical record abstraction (“Claims+MR”); or both types of feedback plus a practice-based DRN (“DRN”). For the 12 months prior to the intervention and 12 months post-intervention, performance data on diabetes related processes of care (annual HbA1c testing, annual LDL cholesterol screening, annual hypertension screening, annual eye, foot, and renal assessment) and patient outcomes (HbA1c level, LDL cholesterol level, blood pressure) were collected from medical record abstraction and Medicare claims data. Pre-post change scores will be compared between intervention arms to examine effectiveness of physician profiling and care coordination by a diabetes resource nurse.

Inclusion Criteria:

• age ≥ 65 years on January 1, 2000
• diagnosis of diabetes mellitus
• diabetes related visit to HTPN physician within the past year
• Resident of Texas
• Medicare insurance coverage

Exclusion Criteria:

• Patient chart not available for abstraction