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Carriers Ramp Up War Against Diabetes

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Life insurers, disability insurers, long-term care insurers and health insurers all suffer losses due to the diabetes epidemic, and health insurers contributed heavily to a recent academic journal section that focused on the war against the condition.

Staffers at America’s Health Insurance Plans (AHIP), UnitedHealth Group Inc. (NYSE:UNH) and the Lewin Group, a research affiliate of UnitedHealth, appear as the authors of some of the articles published in the latest issue of Health Affairs.

Health Affairs is a peer-reviewed journal that covers health care delivery and finance.

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Jeff Lemieux and Teresa Mulligan of AHIP, Washington, were on a team with researchers from XLHealth Corp., Baltimore, that compared diabetes management performance of a managed care plan designed for Medicare Advantage with  specific health problems with the diabetes management performance of traditional fee-for-service Medicare.

The researchers found that the Medicare Advantage chronic condition special-needs plan managed to get participants to see their primary care doctors 7% more often and spend 19% fewer days in the hospital. When the special-needs plans entered the hospital, then left, they were 28% less likely to be readmitted.

This special-needs plan did an even better job at improving results for enrollees who were not white: the specialized plan increased primary care physician visits 26% for non-white enrollees and reduced the number of days they spent in the hospital 27%.
 
“Although this study does not include a cost analysis, we believe that savings from reduced hospitalizations are likely to more than offset the additional costs of enhanced primary care programs,” the researchers conclude.
 
Deneen Vojta and three other executives at UnitedHealth, Minnetonka, Minn., wrote about a national payer’s views on how to handle patients who are at risk for developing diabetes but who do not yet have diabetes.
 
If current trends continue, the percentage of U.S. adults with diabetes could increase to about 20% to 33%, up from about 10% today, Vojta and her colleagues write.
 
About 100 million people could be diagnosed with having prediabetes over the next decade, and the country could spend about $512 billion per year on handling diabetes and prediabetes as early as 2021, the executives add.
 
The executives suggest that the country needs to develop new kinds of coaching programs that encourage patients to change their lifestyles.
 
Christel Villarivera of the Lewin Group, Falls Church, Va., and four colleagues wrote about the need to add diabetes screening for adults at high risk of developing diabetes to the U.S. Preventive Services Task Force routine screening recommendations.
 
The task force now recommends routine diabetes screening only for adults who have high blood pressure, the researchers write.
 
The researchers say there is solid evidence to support the idea of making routine screening available for other groups of people, such as people who are obese.
 
Normally, to avoid increasing health care costs without good cause, the preventive care task force demands to see evidence of long-term gains from a test before recommending the test, Villarivera and colleagues say.
 
In the case of diabetes, however, “requiring long-term, randomized clinical trials of screening- detected versus clinically detected diabetes may be unrealistic, given logistics and costs,” the researchers say.
 
There is no firm evidence that screening high-risk groups other than those with high blood pressure reduces the risk of death or serious, diabetes-related disabilities, but there is evidence screening the high-risk groups may reduce the likelihood that people in those groups will develop Type 2 diabetes, and simply reducing the odds that people will develop Type 2 diabetes should justfy adopting broader screening guidelines, the researchers say.
 
-alb