Take Action to Reduce the Impact of Diabetes
Help your clients take control over soaring diabetes-related costs with HealthSmart’s comprehensive approach to diabetes management
by Monica Schwindt, MCN, RD, LD, CDCES | Registered Dietitian & Certified Diabetes Care and Education Specialist
November is Diabetes Awareness Month and National Diabetes Month. Today, more than 100 million Americans are living with diabetes or prediabetes, according to the American Diabetes Association. The incidence of the disease is rapidly increasing. As the nation and the world prepare to focus attention on those living with diabetes and prediabetes, and celebrate the advances being made in the treatment of the disease, your clients should know about the range of services that HealthSmart offers to address this disease and its potential complications.
An analysis of HealthSmart’s claims data shows that diabetes is one of the top diagnoses for our members. The financial toll, not to mention the physical toll, the disease is taking on health plans and their members is staggering.
• $1 out of every $4 in U.S. health care costs is spent on diabetes or related conditions.
• $237 billion is spent each year on direct medical costs, and another $90 billion on reduced productivity.
• Diabetes is not only debilitating in its own right, it is also a major contributor to other severe conditions, including heart disease, blindness, and vascular disease leading to amputation.
• 48 to 64% of lifetime medical costs for a person with diabetes are for complications related to the disease – heart disease, stroke, and kidney disease.
HealthSmart’s comprehensive Diabetes Management Program helps clients get ahead of the diabetes cost curve.
HealthSmart’s Diabetes Management Program produces real results for your clients and their members dealing with diabetes. The Disease Management Diabetes Management Program along with our Specialty Case Management team helps members and plan sponsors avoid potentially catastrophic claims, averaging an overall seven to one ROI. Additional results include:
• 35% reduction in ER visits
• 47% reduction in hospital admissions per 1,000
• A nearly 50% reduction in per-member per-year costs
• 79% average savings on dialysis costs.
The National Institutes of Health (NIH) reports diabetes is the leading cause of chronic kidney disease (CKD). That’s why, in addition to HealthSmart’s Diabetes Education and Disease Management Programs, our Specialty Case Management services also address chronic kidney disease, kidney transplant, and dialysis as components of our comprehensive diabetes management approach. This coordinated approach follows the all-too-frequent health journey people with diabetes follow and works to diminish risk factors along the way.
HealthSmart understands how CKD can progress, resulting in costly treatments of last resort, such as life-saving dialysis and/or kidney transplant. These treatments are not only difficult for affected members, they can also cost your clients’ health plans hundreds of thousands of dollars. In fact, all-cause costs in commercial groups increase exponentially with advanced stage kidney disease -- $7,537 (no CKD) to $76,969 (CKD stages 4-5).
Our sophisticated care management services address members with diabetes challenges regardless of where they are in their health journey with diabetes. Our comprehensive approach can mitigate triggering stop loss coverage, reducing the financial burden on your clients’ bottom line.
HealthSmart’s proprietary coordinated diabetes solutions include:
• A six-week Diabetes Education Course tailored for members with type 1 and type 2 diabetes using the “teach-back” methodology. Our online course covers fundamental topics such as diet, exercise, medications, and monitoring, to provide members with the knowledge and support they need to properly manage their diabetes.
• Our Disease Management program provides education and support to members living with chronic conditions, and diabetes is the most prevalent condition we manage through this program. Our registered nurses, and registered dietitians with certifications in diabetes care and education, provide one-on-one counseling and support to empower our members to take control of their health and reduce their risk of diabetes-related complications.
• Our Chronic Kidney Disease Case Management program was developed to support our members who have progressed to stage 3 CKD or higher. Our care management team provides the support needed to allow members to minimize the comorbidities and risk factors that contribute to the progression of CKD to end-stage renal disease. This program can halt or delay advancement of CKD.
• Dialysis Case Management lowers costs (averaging $800,000 per year) while assuring the best care. Members who have end-stage renal disease and need dialysis are identified by precertification or predictive modeling and then paired with a team of a registered nurse, a dietitian, and a PharmD, to encourage compliance and provide help navigating what can be a complicated system of care.
• If the member’s condition requires kidney transplant, our Transplant Case Management solution addresses the costs of organ transplantation and maximizes clinical outcomes. We work with the member with diabetes and his or her providers to achieve better health outcomes and optimal health care interventions. The program accesses a best-in-class network of transplant providers to ensure patients receive the highest standard of care and best possible outcomes. Our proven approach employs end-to-end case management from the initial evaluation through post-transplant care.
Learn more about HealthSmart’s comprehensive approach to managing the care of members with diabetes throughout the continuum at our webinar, December 13, 2022, 1:00-1:30 pm EST. Register now!
About the Author
Monica Schwindt, MCN, RD, LD, CDCES is a Registered Dietitian and Certified Diabetes Care and Education Specialist with a Bachelor of Science degree in Neuroscience from the University of Miami. Monica completed her dietetic internship and received her Master of Clinical Nutrition degree at UT Southwestern Medical Center in Dallas. Monica became nationally certified in diabetes care through the Certification Board for Diabetes Care and Education in 2020. She has been with HealthSmart for 4 years. She has experience providing medical nutrition therapy in multiple acute care, outpatient, and telehealth settings to adult and pediatric patients with diabetes, kidney disease, heart disease, organ transplantation, and other medical conditions. Her passion lies in nutrition counseling and diabetes self-management education.