Managed Care - January 2009 - (Page 37)

port shows that 17.5 percent of its members with diabetes received optimal care. The performance of each medical clinic that serves HealthPartners is published in the report. Provider pride “There’s a profound professional pride in delivering high quality and being able to report that on a public basis,” Courneya says. “The way we report the diabetes measures effectively aligns all the incentives to create some substantial improvements.” HealthPartners worked with a local employer to target workers at risk for diabetes and heart disease — and improved the workers’ health status and productivity while reducing their medical claims. BAE Systems, a defense and aerospace company with 1,400 workers in the Minneapolis area, introduced a workplace wellness program in 2004. Its Direct medical costs: $116B/year iabetes is one of the costliest challenges that health plans face — and the one with the greatest opportunities, because most diabetic cases are preventable. Almost 8 percent of the U.S. population — 23.6 million Americans — has diabetes, although the disease remains undiagnosed in nearly a quarter of them. The unpreventable Type 1 diabetes accounts for between 5 percent and 10 percent of all diagnosed cases of diabetes in adults. Type 2 diabetes, which is associated with older age, obesity, family history, physical inactivity, and race/ethnicity, is considered an epidemic. The Centers for Disease Control and Prevention reports that diabetes is the seventh leading cause of death among U.S. adults, although it also says death certificates almost certainly underreport diabetes’ toll because it is so often coupled with other chronic diseases. In 2007, diabetes costs in the U.S. were estimated to be $174 billion. Of that amount, $116 billion was for direct medical costs and $58 billion for disability, work loss, and premature mortality. Because diagnosis and treatment of diabetes continue to lag far beyond clinicians’ ability to treat the disease, more than 20 groups have signed on to support a National Diabetes Goal: By 2015, forty-five percent of all Americans at risk for type 2 diabetes will know their blood glucose levels and understand what they need to do to avoid developing diabetes. D Prevalence of diagnosed and undiagnosed diabetes in the United States 23.6 23.5 23.1 Number (millions) Percent of population 10.7 7.8 12.2 12.0 11.2 11.5 10.2 Total (all ages) 20 or older 60 or older Men Women Newly diagnosed cases of diabetes, 2007 Age Number 20–39 281,000 40–59 819,000 60+ 536,000 Treatment with insulin or oral medication Adults with diagnosed diabetes, 2004–2006 Insulin and oral medication 13% No medication Oral medication only 16% 57% 16% Sources: Centers for Disease Control and Prevention, 2007; National Health Interview Survey estimates Insulin only Numbers do not add up to 100 because of rounding JANUARY 2009 / MANAGED CARE 37

Table of Contents Feed for the Digital Edition of Managed Care - January 2009

Managed Care - January 2009 Editor's Memo Contents Legislation & Regulation News and Commentary Medication Management Compensation Monitor Health Care's Disruptive Innovations Q&A With Clayton Christensen 'Disruption' May Be Plans' Best Bet Avoid the PBM Rebate Trap HealthPartners Puts Diabetes on Notice Formulary Files Plan Watch Tomorrow's Medicine Ad Index Outlook Unmet Needs in the Management of Plaque Psoriasis Impact of RSV: Implications for Managed Care

Managed Care - January 2009

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