How Many Points
Glucose Metric
How Many Points Triglycerides
How Many Points
HDL/Ratio
How Many Points
Blood Pressure
Reasonable Alternative Standards
100

Diabetic.  Glucose and A1C dated 7/2026: Glucose = climbed to 125, A1C=6.9. 

14 points for diabetic exception=HgbA1c <7.0.

100

Current Labs: TG=178.  Prior labs: TG=225.

14 points using exception "TG trending down less than 180".

100
  • PCP f/u with no meds prescribed; Male
  • 6/11/26: HDL=39  Ratio= 5.4
  • 6/4/25:  HDL=38   Ratio 5.5
  • 6/2/24:  HDL=32  Ratio=4.9

HDL and Ratio abnormal on meds (or)MD Supervision=

7 points


100

Participant takes Lisinopril.  BP last vist=138/86-BP log requested by nurse and f/u with PCP if BP remained elev.  BP today=140/92-BP log completed with elev readings. How many points?

7 points--not "first time".

100

True or False:  A RAS is the same thing as an exception

No. A RAS differs from an exception in that an exception prevents a participant from dropping to a lower phase whereas a RAS allows a participant to ultimately advance to a higher phase if the alternative is completed. If the participant meets the alternative set by the nurse, at the 4 month f/u appointment, they will advance to the next level of points on that metric.

200

Truist participant.Prediabetic. Glucose trending down from 116 to 115. A1C trending up from 6.1 to 6.5.

14 points. 

200

Prior TG=155, Current TG=179

TG are trending up=7 points

Exception  "TG trending down <180", under MD sup" WOULD NOT APPLY


200
  • Male--no meds recommended by PCP
  • 6/11/26: HDL=39  Ratio= 5.4
  • 6/4/25:  HDL=43   Ratio 5.5
  • 6/2/24:  HDL=41  Ratio=5.2

1st time no trend for HDL = 14 points

200

On meds:

7/2026: BP=142/80

3/2026: BP=130/84

12/2025:BP=128/85

First time no trend=14 points

(Normal = >/=130 over >/=85)

200
How frequently does a participant have to be seen when utilizing a RAS?

Every 4 months (except for RAS's related to preventives/labs).

300

Non-diabetic

7/2024 Glucose = 106. Glucose on 11/18/25 is 113. HgbA1C from 11/1/25 is 5.4


Use exception:  HbA1c<5.7 and under MD supervision=14 points

300

6/2026: TG=256. Had MD f/u and repeat TG=174.


14 points - Use exception "Participant provided follow-up labs".

300
  • Male--no meds recommended by PCP
  • 6/11/26: TC= 241 HDL=47  LDL 150 Ratio= 5.1
  • 6/4/25: TC=288 HDL=39 LDL=190 Ratio=7.4
  • 6/18/24:TC=270 HDL=41 LDL=175 Ratio=6.5

7 points - nurse should reach out for a 2nd level review due to significant improvements

300

No meds

6/2026: BP=140/86-no log 

2/2026: BP=142/90 (BP log recomm and MD f/u PRN)

10/2025: BP=128/84

7 pointsno log

14 points if participant had of kept BP log/MD f/u as instructed at 1/2026 appointment

300

Can a participant request more than 1 RAS per appointment?

Yes.  But they would have to complete 1 alternative for each metric.  Example:  If a participant requests a RAS for body fat and waist circumference, they would have to complete 2 alternatives: ie food log and exercise log

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