WellCare's Initiatives To Improve Care for Members With Diabetes

John A. Johnson, MD, MBA: Type 2 diabetes has become an epidemic in the United States, and at WellCare, we consider it one of our top priorities because most of the members we serve have type 1 or type 2 diabetes. We rank that very high in our priority along with hypertension, hyperlipidemia, [and] heart and cardiovascular diseases such as heart failure, myocardial infarction, and stroke. Diabetes is a risk factor for all of the other types of cardiovascular diseases, [and therefore] all of our programs are designed to eradicate or treat diabetes as best as possible.

At WellCare, we have what’s called our case and disease management programs. These are programs that partner with the providers and patients (or members we serve) to help improve the outcomes of [a patient’s] disease. From a cost-avoidance perspective, we try to enhance the quality of services that our members receive by providing wraparound services or support. For example, with diabetes disease management, this involves a nurse or social worker identifying patient-centered barriers to care—whether access, transportation, or care gaps—and [working to figure out] how we can help that patient, or member of ours, get the services that they need and prioritize their care from their perspective.

At WellCare, this is a very big priority [and a reason why] all of our programs are interwoven. For example, we also have a program called Advocacy. Our Advocacy program identifies social-economic barriers that our diabetics may have in their communities—whether they live in a food desert where they don’t have access to healthy nutrition or they lack an ability to participate in an exercise program, carb counting, or meal planning. So, our Advocacy program identifies community partners that we can work with to enhance those services in a collaborative way.

Again, diabetes is at the core of what we do, and is the disease that we manage. Our belief is that if we can connect those patients (our members) to these services, then downstream, we can improve quality, improve clinical outcomes, and enhance the member experience.