Helping Our Members Take Control of Their Diabetes
At Tufts Health Plan, we’re working hard to achieve better outcomes for our members with diabetes, through proactive care management and close collaboration with providers
People with diabetes have medical expenditures approximately 2.3 times higher on average than they would in the absence of the disease
According to the Centers for Disease Control and Prevention (CDC), more than 29 million Americans have diabetes, and 86 million more have prediabetes—that’s about 45 percent of the U.S. workforce. Meanwhile, 1.5 million Americans are diagnosed with type 2 diabetes every year. While the rate of new cases has slowed somewhat, the prevalence of diabetes continues to rise.
Diabetes can have a profound impact on the lives of people who have it. In addition to daily routine care—including pinpricks to monitor blood sugar levels, insulin injections, and diet restrictions—there are potential complications ranging from cardiac and kidney disease to depression and nerve damage. Diabetes remains the 7th leading cause of death in the U.S.
The financial cost of diabetes is also high:
- People with diabetes have medical expenditures approximately 2.3 times higher on average than they would in the absence of the disease.
- The direct medical cost of diagnosed diabetes in the US in 2017 was $237 billion.
- 60% of the cost of diabetes is paid for by private insurance.
- Diabetes costs the U.S. $90 billion in lost productivity, between absenteeism, reduced productivity at work, and inability to work due to disease-related disability.
The direct medical cost of diagnosed diabetes in the US in 2017 was $237 billion
At Tufts Health Plan, our goal is to help our members with diabetes successfully manage their disease, live well, and avoid complications—which, in turn, helps keep costs in check
It starts with promoting healthy eating, exercise, and regular preventive care and screenings to all of our members, to help keep them from developing diabetes in the first place. From there, we identify and reach out to members with diabetes who may benefit from the dedicated, one-on-one support of our diabetes care management program.
Diabetes costs the U.S. $90 billion in lost productivity, between absenteeism, reduced productivity at work, and inability to work due to disease-related disability
The first step is creating a personalized care plan for each member, based on their identified goals, evidence-based assessment, and the physician’s plan of care. Members can also opt in for telephone support from a dedicated nurse care manager, who will coach them toward appropriate care, medication, lifestyle choices, and screenings, and even refer them to community resources for financial and social support.
What makes our approach to diabetes care management unique is our emphasis on education and ownership
Educating patients about diabetes is widely recognized as one of the best ways to improve compliance and minimize complications. We take that a step further, encouraging our members to take full ownership of their health and care.
It has to be the member’s plan, not my agenda. What would they like to work on? What’s their first priority? Sometimes it’s as simple as making an appointment with their primary care physician, starting to take medications, and checking their blood sugar.
-Sharon Soucy, Care Management Relationship Manager, Tufts Health Plan
Our nurses also work with our behavioral health clinicians to make sure members are getting all the tools they need to help change behaviors and be successful. With the added convenience of telehealth, members can check in when it works best for their schedules.
Our care managers also coach patients on strategies for effective communication with providers, encouraging them to write down questions and topics for discussion at their appointments, such as the effects of a medication, or when to call to avoid a crisis. Soucy explains, “It’s our goal to help members see that they can be advocates for themselves.”
Research has shown that our approach can have a dramatic impact: By educating newly diagnosed patients on the importance of consistent blood sugar testing and the long-term complications of unmanaged diabetes, as well as lifestyle and diet changes that can help stabilize blood sugar levels, blood pressure and cholesterol, our nurse care managers have helped members achieve better compliance, blood sugar control, and quality of life.
As the prevalence of diabetes keeps rising, Tufts Health Plan will keep finding new ways to help our members with diabetes stay healthy, happy, and productive. Learn more about our care management programs for diabetes and other chronic conditions.
We also collaborate closely with providers, for a 360-degree approach to diabetes care management
The strong provider relationships Tufts Health Plan is known for are especially important when it comes to complex conditions like diabetes. By efficiently coordinating services and communication across each member’s primary care physician or endocrinologist, specialists, and home care services, if applicable, we can ensure every member gets the right care at the right time, from routine monitoring and screenings to specialty care.
We also support our providers in their efforts to prevent and treat diabetes in innovative ways: One recent example is our investment in the Asian American Diabetes Initiative at Joslin Diabetes Center. This program offers elderly Asians with, or at risk for, diabetes the opportunity to take part in educational workshops and seminars focusing on exercise, improved diet, and the prevention of diabetes complications.