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Diabetes outreach improves, but more work needed: NBCH

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Insurers are slowly improving their outreach to and management of patients with diabetes, but considerable room for improvement remains, according to the National Business Coalition on Health's “2009 Health Plan Diabetes Performance” report.

The report, released Tuesday, is based on health plan survey data from the Washington-based NBCH's eValue8 program, a request-for-information tool used by employers and coalitions to set expectations and measure health plan performance.

For example, although 85.1% of diabetic patients covered by the surveyed health plans had at least one annual hemoglobin A1C test, blood sugar levels remained uncontrolled in 43.3% of those patients. The findings were a slight improvement from 2008, when 82.7% of diabetic patients covered by the surveyed plans had regular hemoglobin A1C testing and 46.8% had uncontrolled blood sugar levels.

Among other findings in the annual NBCH report:

  • Nearly all health plans responding to the survey offered personal health assessments to help identify patients who have or are at risk of developing diabetes, but only about 3% of plan members actually complete them. Moreover, while 87% of plans include personal health assessments for fully insured plans, just 67% do so for self-insured employers.

  • Disease management continues to be a core service of health plans, with 90% offering it to all self-insured customers; however, at least 10% offer it as an unbundled service that costs self-insured employers additional fees.

  • Sixty-one percent of insurers surveyed recognize doctors who have met the National Committee for Quality Assurance's criteria for treatment of diabetes, but only 16% provide searchable online directories of these physicians for plan members.

  • Ninety-five percent of health plans have the ability to report gaps in patient care or quality of back to physicians, an increase from 87% in 2008. In addition, 70% of plans can show physicians how they compare with their peers, up from 51% in 2008.

    • Dennis White, senior vp of value-based purchasing at NBCH, said the report shows that “the health plans are making a lot of progress. They have developed and set in place very good tools to promote healthy behaviors and improvement in health status. Now the challenge is getting consumers engaged, using the tools, but also better coordination with employers for things like plan design and cultural reinforcement, and doctors to track and act on gaps in care.”

    The report is available at the NBCH's Web site at http://nbch.org.

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