5 Lessons From Patient-Centered Diabetes Care

Last week, The American Journal of Managed Care and Joslin Diabetes Center presented the 4th annual conference, Patient-Centered Diabetes Care. This gathering of stakeholders from across healthcare—physicians, payers, health system administrators, pharmacists, diabetes educators, and patient advocates—came just after the news that Medicare will soon pay for the National Diabetes Prevention Program (NDPP). With that to discuss and so much more, here are 5 lessons from the April 7-8, 2016, conference in Teaneck, N.J.:

1. The future is all about prevention. CDC estimates that 86 million Americans have prediabetes, and the healthcare system cannot sustain a continued advance of type 2 diabetes as the population ages. Experts believe CMS’ decision to fund diabetes prevention will have a ripple effect; once commercial payers in Medicare Advantage become familiar with the program—and see the savings—they will promote prevention to younger enrollees in employer-based plans.

2. Diabetes is going digital. The evidence-based NDPP has been effective as a face-to-face program, but scaling it to reach all who need it in Medicare will demand new solutions—ones that don’t require office visits or classes. Mike Payne, chief commercial officer of Omada Health, discussed how his company is ready to bring NDPP to the masses. Keynote speaker Lonny Reisman, MD, shared how Big Data can change the nature of clinical trials and population health.

3. But, reimbursement needs to catch up. A panel on telehealth showed how technology can play a role on the treatment side, too. At the University of Mississippi Medical Center, researchers have equipped at-risk type 2 patients with iPads to track clinical indicators and bring them lessons in self-care. So far, the effort is keeping patients out of the hospital. However, reimbursement policies at CMS have generally kept telehealth from achieving these kinds of results with the patients who would benefit the most.

4. Stigma is a barrier to good obesity care. Evidence is mounting that medications and bariatric surgery can help patients with obesity lose weight, and reverse diabetes for many. But stigma from employers, insurers, and even physicians keeps this population from getting the help it needs—93% of their medical needs are unmet. Ted Kyle, RPh, MBA, of ConscienHealth and the Obesity Action Coalition, said stigma not only harms patients, it also ends up costing more when they suffer serious health problems. “Whether or not healthcare plans cover care for obesity, we are paying for obesity,” he said.

5. Consumer demand is driving care to new places. Patients who need regular diabetes care aren’t willing to continually miss work, so retail clinics are giving them a new option. Putting care where patients are—in pharmacies, even grocery stores—makes it easier for those with chronic disease to seek treatment and adopt healthier lifestyles. Pharmacists—who may see patients several times a week—are an underused resource in diabetes care.