Medicare beneficiaries understand the difficulty of navigating today’s health care system, and for the more than 25 percent of seniors living with diabetes like CMC member Bertha Shinn, it’s even more complicated. Beneficiaries often see several doctors and specialists, who are all monitoring their health and prescribing drugs. Many seniors with diabetes not only see a primary care physician, but also an endocrinologist (doctor specializing in treating diabetes), ophthalmologist (eye doctor), and podiatrist (foot/lower leg doctor). And, ideally, they also receive care from a dietician, diabetes educator, and exercise trainer.
Monitoring care across providers is important because those who have been diagnosed with diabetes have an increased risk for many serious health problems. The disease is the leading cause of kidney failure, lower-limb amputations (other than those caused by injury), and new cases of blindness among adults. In fact, one in three Medicare dollars is spent caring for people with diabetes.
Seniors with diabetes also have an increased risk for many serious health problems. The most common complications include skin infections and disorders, glaucoma (which can result in loss of sight), cataracts, and neuropathy (nerve damage). Diabetic seniors also often develop other chronic conditions like kidney disease and high blood pressure, and have a higher risk of stroke. Fortunately, with the correct treatment and recommended lifestyle changes, many people with diabetes are able to prevent or delay the onset of complications.
As part of the MACC Task Force’s Care for Us Project, we developed a Care Coordination Pocket Guide, that includes a list of five questions every Medicare beneficiary and their caregiver should ask for in writing at every transition of care. In honor of National Diabetes Awareness Month, we’ve adapted the questions for beneficiaries with diabetes to bring to medical appointments, as they visit multiple providers across specialties.
- What are you treating/or seeing me for and how does it affect my diabetes?
- Are you changing my prescription or care? If yes, can I please have a copy and an explanation of what has changed, why, and how it may affect my current diabetes medication and diet/exercise plan?
- What special instructions can you provide for me/my loved one when I leave here? Are there any instructions I should be aware of regarding my blood sugar monitoring?
- When should I follow up with you or my other health care provider(s)? Are there any additional diabetes education resources you would recommend?
- If I have more questions about this appointment or my diabetes care, whom should I contact?
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. Often times, a patient’s primary care physician will serve as the “care coordinator,” but others – such as nurses, social workers, or other providers – can also serve in this role.
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 plans, 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.
In order to help raise awareness, Coalition’s Medicare Advantage Care Coordination (MACC) Task Force recently announced the launch of the Care for Us Project, a campaign to build awareness around best practices related to care coordination and disease management of specific chronic conditions prevalent among Medicare beneficiaries. Through the Care for Us Project, the MACC Task Force provides chronic care resources to beneficiaries, their family members, providers and the broader policy community on an ongoing basis and focuses on particular health conditions, including diabetes. You can follow the release of these new materials here. You can also follow the Task Force via the Coalition’s Twitter feed and Facebook page.