During Diabetes Awareness month (November) – and every month – someone is having a limb amputated due to diabetes every three-to-four minutes here in the United States. These patients often come from traditionally underserved populations, including Black and Latinx communities, that disproportionately experience the clinical and economic burdens of diabetes.
Getting ahead of rising patient risks can greatly improve quality of life and reduce the incidence of complications from diabetes, such as preventable foot ulcers. It can also help cut spending by $9,800 to $14,000 per patient each year.
America’s health plans have a major opportunity to pull back the curtain on health disparities, and take a hard look at what we can do to make preventive care a priority for all patients with diabetes.
Understanding the true size and scope of minority populations living with diabetes
Today, many analytics and risk stratification initiatives are built by using diagnosis and service codes to place individuals into defined disease buckets that end up prioritizing one disease state over the other without creating a full understanding of cause and effect.
For example, people with open diabetic foot ulcers, which often indicates poorly controlled diabetes, are more likely to experience additional issues, including being 30 times more likely to have a lower limb amputation, eight times more likely to be hospitalized for peripheral vascular disorders, and about two times more likely to be hospitalized for renal failure, congestive heart failure (CHF), pulmonary edema, chronic obstructive pulmonary disease (COPD), or a heart attack.
As a result, we think of downstream spending on cardiovascular disease as the primary cost driver – not diabetes – and allocate our dollars accordingly. That leaves the needs of the rising-risk diabetes population unaddressed and inaccurately minimizes the costs associated with this small but very high healthcare spend population.
Health plans need to gain visibility into all the costs and codes associated with diabetes care and common comorbidities, and that includes important changes like prioritizing integration of Social Determinants of Health (SDOH) data into predictive algorithms that serve the best interests of all patients.
Reframing the partnership between health plan and member
Working directly with community representatives can also help health plans understand the touch points that matter most to the people they serve. For example, faith-based groups can be ideal partners for making a big impact on education and building connections, since they are strong fellowship hubs that can host diabetes screenings, hold nutrition classes, or simply partner with health plans to reinforce the importance of making positive lifestyle choices.
Organizations like the Partners in Health and Wholeness (PHW), a multi-faith program developed by the North Carolina Council of Churches, is one such group that fosters healthy communities through events, financial support, and peer-to-peer education that reaches beyond the traditional clinical sphere of influence.