Point of care Hemoglobin A1c (HbA1c) Testing

Hi this is a small FaQ i found on a web site while studing HbA1c

Ø What is point of care HbA1c testing and what are the advantages?

The ADA recommends at a HbA1c tests be performed at least once every six months on every patient with diabetes who are meeting goals, and more frequent testing for those patients who are not meeting treatment goals. HbA1c testing can be done at the time of the patient’s visit, so that results are available immediately, which give the healthcare provider a real time advantage in facilitating self-management goal setting with the patient. The testing kits used are single use, disposable, self-contained qualitative tests for HbA1c and results are comparable to laboratory testing. They can be used in a physician’s office or by the patient at home (with a prescription). It takes approximately 7-8 minutes to complete the test.

Ø What kind of staffing is required to do the test?

The test requires that office staff perform a finger stick on the patient being tested, then run the test on the machine. Most medical assistants are generally trained to do finger sticks, and can be reasonably expected to do the test.

Ø How long does it take to do the test?

While time requirements might vary by specific machines, it generally takes a total of 7 minutes or less to do the test: approximately 1 minute to do the fingerstick and run the machine, and 6 minutes to get the results from the machine.

Ø How much does the HbA1c testing machine cost?

These machines cost around $3,000. Some of the vendors for machines include:

· Bayer DCA 2000 Plus System

· A1cNow Monitor

Ø What is the “per test” cost for doing this in the office?

Costs of doing the test can be broken down into the following:

· Test kit: Typical patient testing kit costs around $8.00- $10.00 (they come 10 to a box).

· Quality controls: Need to purchase “High” and “Low” reagents for quality control testing once/wk. Kit with reagents costs approx $93 and supports approx 100 quality control tests being done (therefore, costs approx $1/wk).

· Staff time: 7 minutes of medical assistant time

Ø What is does an office typically charge and get reimbursed for doing this in the office?

A typical charge for this service is around $49.00, with an average expected reimbursement per test of $13.00 to $20.00.

Ø Does doing this test require any special type of lab certification?

Rapid HbA1c testing is a CLIA-waived lab test. No special certification is required to do this in PCP offices.

Ø Why do point of care testing?

The ease and accessibility of the test at the time of patient visit enables efficient, cost-effective testing and may result in greater patient compliance. A recent study from Diabetes Care also suggests that point of care HbA1c testing can help improve glycemic control

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