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This Week in Managed Care: July 30, 2016
July 30, 2016

Cleveland Clinic Affiliates With Unique Diabetes, Obesity Initiative in Mississippi

Mary Caffrey
The institute is part of a planned development by Joseph Canizaro, who grew up in Biloxi and has transformed New Orleans' skyline over 4 decades.
An effort to find cures for diabetes and obesity in a place where both are prevalent—Mississippi—has attracted help from one of the best-known names in diabetes and cardiovascular care, the Cleveland Clinic.

On Friday, the National Diabetes and Obesity Research Institute (NDORI), announced an affiliation from the Cleveland Clinic Endocrinology and Metabolism Institute, with the goal of making the South Mississippi center a national leader in research and development of better treatment protocols.

The affiliation was big news in a state where the government’s top leaders are fed up with what diabetes and obesity are doing to the health of its citizens and its economy. Last year, state Medicaid officials made a significant policy shift by agreeing to pay for bariatric surgery. Friday’s announcement attracted Mississippi Governor Phil Bryant, who told local reporters:

“This is about lives. It's the best investment we can make,” he said. “This is a public private partnership that will literally change lives in the direction of healthcare in Mississippi, and all the world will know the Cleveland Clinic has come to the Gulf Coast.”

CDC statistics for 2014 put the share of Mississippi’s population with diagnosed diabetes at 11.9% and other estimates put the percentage at 13%. A CDC state profile lists the obesity rate at 35.1% and found that two-thirds of the population is at least overweight, with a BMI above 25. Also, 38% of adults said they had not had any physical activity in the past month.

NDORI is a story by itself. This up-from-the-ground effort to tackle diseases that put Mississippi on the wrong end of too many healthcare lists is the brainchild of native son Joseph Canizaro, who has singlehandedly altered the skyline of New Orleans since moving there in the 1960s.

Canizaro grew up in Biloxi, Mississippi, the Gulf Coast city transformed in recent years by casino gambling and by rebuilding after Hurricane Katrina. Canizaro has type 2 diabetes (T2D), and he has positioned NDORI as a focal point of Tradition, Mississippi, a planned community north of Biloxi at the edge of the DeSoto National Forest. NDORI promises to bring brick-and-mortar and jobs along with clinical and research expertise to combat diabetes and obesity. Its website describes the initiative as a collaboration of national healthcare leaders, federal and state agencies, and area colleges.

How did NDORI connect with the Cleveland Clinic? Richard Shewbridge, MD, an endocrinologist at the clinic who will serve as executive medical director for the partnership, told The American Journal of Managed Care in an interview that a year ago, Canizaro approached the world-famous institution with his idea for the NDORI and the center.

About 10 months ago, Shewbridge received a call from leaders at Cleveland Clinic with a question: Would he want to help start a “big project” in the state of Mississippi to work on diabetes?

“You don’t get many calls like this in your career,” Shewbridge said.

The longtime endocrinologist had a connection to the area: in the early 1990s, he did a residency in internal medicine at Keesler Air Force Base in Biloxi. The base hosts a medical center that treats 27,000 service members and their families, as well thousands of military retirees who live between Mobile, Alabama, and New Orleans.

According to Shewbridge, the affiliation with between Cleveland Clinic and NDORI will have 4 core areas:

·         Registry-based research. Shewbridge said area providers are already interested in participating, “so we can put the power of big data to use for this population.”

·         Diabetes education and improvements in care. The Cleveland Clinic’s institute will share its clinical protocols with caregivers in the region.

·         Diabetes and obesity care paths. This value-based element will help standardize care and reduce the cost and variability of care, Shewbridge said.

·         Clinical research. This element will take the longest to create, as it calls for the Cleveland Clinic partners to help find a head of research, and well as the construction of facilities.

While some parts of the partnership will await infrastructure, the knowledge-sharing aspects can start right away. “Mississippi needs help now,” he said.

NDORI will collaborate with other state efforts to combat diabetes, notably the telehealth programs at the University of Mississippi Medical Center, which were featured as at the most recent meeting of Patient-Centered Diabetes Care. “The governor is very interested in having us align with those efforts, and we are looking forward to that,” Shewbridge said.

State officials, he said, “are tired of leading the pack in obesity. They’re tired of being No. 3 in type 2 diabetes. They are tired of being at top of the lists and are ready to move the needle.”

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