By definitions, disease management is an approach to patient care where emphasis is placed on “coordination, comprehensive care along the continuum of disease and across healthcare delivery systems” (Sidorov, Paulick & Sobel, 2003, 565).
The Centers for Disease Control and Prevention declare that diabetes and its complications are “common, complex, and costly, presenting formidable challenges to the U.S. health system” (Ettner, et al.,2006, 1222). This makes diabetes management a primary objective for health care providers.
Chartered Health Plan, Inc., is the oldest Medicaid managed care organization in the District of Columbia (PRNewswire, 2012). The program has over 110,000 enrollees who benefit from the disease management programs offered.
The Role of Preventing Disease
This particular program targets local residents in the District of Columbia where the prevalence of diabetes is higher than the nationwide average. (The national average is 8.7% while the District of Colombia has an average of 10.9%).
Research indicates that type 2 diabetes mellitus may be prevented or delayed through pharmacological interventions and, most efficaciously, through lifestyle interventions.
The program makes it possible to systematically translate research findings concerning diabetes prevention and control into practice.
It bundles multiple healthcare resources and interventions in order to enable patient self care.
Studies demonstrate that people who engage in the program are able to manage their disease better.
By ensuring that diabetes is properly managed, the program prevents the development of complications such as blindness and foot problems.
Patient incentives
Patients are provided with guidelines that help them to achieve higher levers of self care.
Achievement of near-normoglycemia improves quality of life for the patient and reduces the economic strain associated with diabetes.
The program enables patients to work closely with physicians so as to facilitate the use of clinical guidelines and makes it possible for early and appropriate specialty referral to be made.
The multidisciplinary approach presents patients with the opportunity to consult with a cardiologist, neurologist, nephrologist, podiatrist, certified diabetic educator, and dietician as needed on a one-stop basis (Salber, 2008). This is very convenient for the patient since it saves on time and monetary resources that would have been used consulting with all this specialists at different times.
The program makes it easy for patients to communicate with physicians. They do not have to wait for emergencies to consult with their doctors which leads to a better relationship and great benefit for both parties.
The program also provides physicians with data that is necessary to make correct diagnosis and therefore recommend the best care for the patient.
Reimbursement for Outpatient Procedures among managed care patients has increase the level of commitment among physicians. Ettner et al. (2006) reveals that physician reimbursement strategies lead to greater levels of service to the patient which increases the level of care and patient satisfaction.
The program enlists the support of nurses who are integral in most diabetes care management. In this case, the nurses asses and monitor the patients conditions through a number of ways including social services and home case. They also provide diabetes education to facilitate the adherence with treatment by the patient.
Through this texting, effective interaction with patients in diabetes care management is possible. Texting technology is not only readily available but it is also very cheap.
Facilities
The program makes use of a text-messaging to send medical information to patients in order to assist in improving self-care
Such a program gives patients access to real-time support
The program helps patients to establish formal relationships with medical facilities within their locality.
Quality of care
The program offers quality and innovative health care services to the patients.
The needs of the patients are assessed at enrollment which makes it possible for individualized treatment plans to be developed and implemented.
Reduced hospitalizations and emergency room visits (Sidorov, et al. 2003).
The mobile technology implemented by Chartered Health Plan improves self-care with positive results.
Prescription benefits
The cost of prescription drugs is also reduced since patients can get drugs from the program.
Consultations between patients and pharmacists result in wider variety of medication therapy for the patient with major benefits
The managed care program encourages lifestyle changes in addition to using drugs to manage diabetes.
Patients can be assisted to calibrate dosages of anti-diabetes drugs from a distance.
The program results in a decrease by up to 1% in patients average HbA levels of diabetes.
Future of data use and informatics
From the available data, disease management support can be focused on patients at risk (Chang, et al., 2007).
The program provides a rich source of data that can be used to assess the effectiveness of certain practices and help establish best practices in diabetes care (Salber, 2008)
The researchers employed by Chartered Health Plan contribute to the knowledge of the effectiveness of many medical practices currently in use on diabetes patients.
Conclusion
This Presentation has reviewed the Chartered Health Plan diabetes disease management program and highlighted its benefits to patients and physicians.
Managed care programs make significant contributions to diabetes care.
This contribution comes from the ability to collect useful data that benefits the patient and helps the physicians to better assist in disease management.
References
Chang, K. et al. (2007). Nurse Practitioner-Based Diabetes Care Management. Disease Mange Health Outcomes, 15(6), 377-385.
Ettner, S.L. et al. (2006). Are Physician Reimbursement Strategies Associated with Processes of Care and Patient Satisfaction for Patients with Diabetes in Managed Care? Health Research and Educational Trust, 41(4), 1221- 1241.
Sidorov, J., Paulick, P. & Sobel, L. (2003). What is the Return on Investment Associated with Diabetes Disease Management? Disease Mange Health Outcomes, 11(9): 565-570.
Salber, P.R. (2008). How managed care organizations contribute to improved diabetes outcomes. The American Journal of Managed Care, 14(1) 9-12.
PRNewswire (2012). New Program Uses Mobile Technology to Help People Manage Diabetes. Web.