The Diabetes Innovation conference in Washington, D.C. this week called attention to the myriad of ways healthcare ecosystems in different parts of the country are approaching diabetes care. But it also offered a glimpse at the broader challenge of treating diabetes and other chronic conditions. Here were a couple of the most vexing issues that came up.
Different ways of measuring outcomes The shifting business model from fee-based services to outcomes based care is the most dramatic change called for in Obamacare. But one crucial concern that has yet to be resolved effectively easily stands in the way of making that shift: differing core measure sets. How do you get physician groups, health systems, payers and the Centers for Medicare and Medicaid to agree on what amounts to an improvement in a diabetes patient’s health and what doesn’t?
It came in response to a question put to one of the panels of experts: If one of your stakeholders could do something to make it easier for you, what would it be? Sam Ho, chief medical officer with UnitedHealthcare, called attention to the basic but inherent problem of differing core measures and said: “Any overlap of methodologies would be purely coincidental…We need to figure out how to crystallize measure sets.”
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Primary care physicians need to identify pre-diabetes The increased responsibilities piling up on primary care physicians also includes being able to identify patients with pre-diabetes and help them better manage their health or make referrals. The consensus from panelists at the conference by Joslin Diabetes Center was there is a critical need to improve primary care physician education. Humana’s Director of Chronic Care Strategies for its Health Guidance Organization Dr. Todd Prewitt observed that physician coding of risk factors for pre-diabetes is “really poor.” He added that under-representing risk factors, such as obesity, is fairly common across the country. “I come from Kentucky where 24 percent of the population smokes but that number is greatly underrepresented.”
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