Why Protecting and Strengthening High Quality, Coordinated Care for Individuals with Diabetes is Critical
NOVEMBER 13, 2015
Last month, our Medicare Advantage Care Coordination (MACC) Task Force launched the Care for Us Project to provide chronic care resources to beneficiaries, their family members, providers and the broader policy community on particular health conditions.
During National Diabetes Awareness Month in November, the Task Force is focusing on diabetes care for people in Medicare. Diabetes affects more than 25 percent of seniors, and in fact, one in three Medicare dollars is spent caring for people with diabetes. With more than 86 million Americans living with prediabetes, the number of diabetic patients is expected to grow over the next several years.
Diabetes is complicated, both in the way it impacts the body and because people who have it often are dealing with other health conditions. Care coordination is important for anyone dealing with a health condition; for the nearly 30 million Americans with diabetes, care coordination can be the key to stopping or slowing the disease’s progression and living a longer, healthier life.
That’s why the CMC is releasing a suite of diabetes tools and resources, including interviews with seniors and MACC Task Force members on how their organizations are helping seniors live as healthy lives as possible.
The MACC Task Force also recently sat down with the CMC’s 2 millionth member, Bertha Shinn. A six-year cancer survivor, Bertha has been living with type 2 diabetes for 25 years and she credits the care that Medicare Advantage provides her as a key to staying healthy. “The great thing about Medicare Advantage is that it gives beneficiaries the opportunity to select the very best providers and the flexibility to find the ones that are right for them,” Bertha said.
In addition to diabetes being highly prevalent among Medicare beneficiaries, more than two-thirds of Medicare beneficiaries have at least two or more chronic conditions, further complicating their care.
“An outstanding amount of people living with diabetes plus other health conditions often receive care and treatment from numerous doctors, take more medications, and make more visits to the emergency department than those without multiple chronic conditions,” said Charles Macfarlane, Chief Executive Officer of the American Association of Diabetes Educators, a member of the MACC Task Force. “This makes care coordination and education through a trained diabetes educator critical components to their care.”
This is why care coordination is so critical for Medicare beneficiaries with diabetes. The goal of coordinated care is to make sure that patients get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors. All together, care coordination activities can make a real difference in the health of Medicare beneficiaries with diabetes – and even save their lives.
While there are many programs aiming to improve the health of people with diabetes, Medicare Advantage is one program that is making a clear difference. This is due in large part to care coordination activities that are central to Medicare Advantage, such as deliberately organizing patient care activities and sharing information among all of the participants concerned with a patient’s care to achieve safer and more effective care, as well as providing support tools like nurse help hotlines, care plans and disease-state education.
Studies have found that beneficiaries enrolled in Medicare Advantage plans are consistently more likely than those in traditional Medicare to receive appropriate diabetes care and that the quality of that care is higher in Medicare Advantage than in traditional Medicare. And receiving appropriate care results in fewer complications and hospitalizations for beneficiaries. Disease management programs for high-risk beneficiaries with diabetes have been found to be effective in reducing hospital inpatient admission and total costs. One study found that a Medicare Advantage disease management program for high-risk diabetes patients significantly reduced hospital admissions, reducing costs by almost $1,000 per patient per year.
These are some of the reasons we are asking you to join us during November as we work with our 2 million Medicare Advantage seniors and a broad array of partners to raise awareness about the importance of high quality coordinated care for individuals living with diabetes.