Panel Discussion: The Role of Heath Plans and Payers in Patient Care

This panel, led by moderator Dennis Scanlon, PhD, Penn State University, asks the question, “Why should a payer or a plan be involved in patient care?” Dr Scanlon is joined by panelists Teresa Pearson, MS, RN, CDE, FAADE; Deneen Vojta, MD; Todd Prewitt, MD, FAAFP; and Amy Tenderich.

Panelists discuss some of the challenges faced by patients with diabetes. One example is that payers play a “gatekeeper role” that affects patients’ decision-making. Patients also face a lack of care-option transparency, and there is a need for greater patient education. Providers share some of the same challenges. If diabetes care is to be truly patient-centered, patients need to have trust in both payers and providers. They also need to be engaged in the decision-making process.

“So I think what people need beyond the set of instructions like, ‘Here's the medications’ or ‘Hey, we'll change those meds,’— how do I succeed with this, how do I deal with social situations, how do I deal with travel, how do I deal with all the things that come up in life that are going to complicate my diabetes care,” says Ms Tenderich. “That’s the kind of help people need, and if they can get it from each other — which I think right now what we are getting is much more there than from traditional providers —that's also incredibly valuable and that should be part of the prescription. It should be built into the system of the way people are treated for this illness.”