The American Journal of Managed Care brought together than 125 diabetes advocates, providers, and educators, along with health plan leaders and pharmaceutical executives, to Princeton, N.J. Attendees gained insights into giving persons with diabetes with the right level of support to manage their disease.
FOR IMMEDIATE RELEASE APRIL 13, 2014
Lessons for Managed Care of Diabetes: Some Help Is Good, but Too Much Contact Confuses Patients
PRINCETON, N.J. — Keeping persons with diabetes on track with medication and lifestyle modifications may require extra contact from health care providers. But these “touches” must be coordinated to avoid making patients confused.
These were two of the many lessons from the second day of “Patient-Centered Diabetes Care: Putting Theory in Practice,” sponsored by The American Journal of Managed Care at the Princeton Marriott at Forrestal. More than 125 attendees took part in the conference, which concluded Friday.
A lineup that included keynote speaker Robert Gabbay, MD, chief medical officer at Joslin Diabetes Center of Harvard Medical School, offered insights on how to strike the right balance between overlooking high-risk patients who skip medications and having too many “coordinators” from the many specialists involved in a diabetic’s life.
Among the lessons from Friday’s sessions:
Two patient advocates with type 1 diabetes, Amy Tenderich of the web-based news source DiabetesMine.com, and Rebecca Killion of McKenna Long & Aldridge, said navigating the healthcare system is more difficult than it needs to be. Both said if they struggle at times as highly informed patients, what is happening to those without education or insurance coverage? Ms. Tenderich perhaps best summed up the need for healthcare to adapt to its clients when she commented on the term “patient-centered.” Said Ms. Tenderich, “As opposed to what?”
Deneen Vojta, MD, of UnitedHealthcare said the next wave of healthcare advances will come on the “operations,” side, and she agreed with the patient advocates that change is overdue. ”We are too quick to blame the patients; we’re constantly talking about non-compliance and non-adherence,” she said. But when it comes to giving patients a voice in the decisions that drive their care, “I don’t think we do a good enough job with that. Patients are too often not front and center in creating their care plan.”
Dr. Gabbay, an expert on PCMH, said this is the best model for organizing a primary care practice. But, he cautioned, “It’s not a panacea. It’s not going to answer everything.”
He was among several experts who said it was impractical to offer intensive interactions for everyone with diabetes, but such efforts are essential for high-risk patients. The key, Dr. Gabbay and others said, is to harness the power of the electronic health record (EHR) to identify patients who have skipped follow-up appointments, failed to fill prescriptions, or whose glycated hemoglobin (A1C) levels indicate they are most at-risk of hospitalization or serious complications, such as kidney disease.
New payment models will reward clinicians who prevent downstream costs. “This is fantastic news for the world of diabetes,” Dr. Gabbay said.
“Diabetes care has always had to argue our value,” he said. Endocrinologists are poorly paid for the amount of care they provide, but Dr. Gabbay said a move away from fee-for-service will reveal their importance. “Now things are flipping around — we are now the answer to how to save dollars,” he said.
Other highlights of Friday’s schedule included:
About the Journal
The American Journal of Managed Care, now in its 20th year of publication, is the leading peer-reviewed journal dedicated to issues in managed care. In December 2013, AJMC launched The American Journal of Accountable Care, which publishes research and commentary devoted to understanding changes to the healthcare system due to the 2010 Affordable Care Act. Full coverage of “Patient-Centered Diabetes Care: Putting Theory into Practice,” will appear in an upcoming issue of Evidence-Based Diabetes Management, a news publication of AJMC.
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