Insurance companies step up services for diabetics

Insurance companies step up services for diabetics

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SALT LAKE CITY — Many more people with diabetes will qualify for health coverage under the Affordable Care Act, so insurance companies are becoming more aggressive in how they treat diabetics to keep costs down.

Like most people with chronic diseases, if diabetics don’t closely follow their treatment regimen, it could lead to much more severe and more expensive problems in the future. But there are steps insurance companies can take to lower their bottom line.

A recent article from Bloomberg BusinessWeek indicates insurance companies will call patients who don’t pick up their medication, and will even arrange transportation to get patients to the doctor.

“Insurance companies are doing this partly because regular physicians have not picked up the ball and started doing this when they bring care to their patients," according to Dr. Timothy Graham with the University of Utah Diabetes and Endocrinology Center. "Partly that has been because there is no infrastructure in place and no plan to make this happen.”

Graham said that most patients who don’t follow their treatment plan don’t do it out of laxity. He thinks they fall from the plan because they don’t fully understand the regimen.

“They need a lot of hand-holding," he said. "Diabetes is a way of life. It’s not just a set of medications that you take.”

The way doctors speak to their patients could be part of the problem. Graham said there has been a dysfunctional system in America for a very long time.

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“We’ve also had a model where, for many years, doctors have looked at patients as (if they were) children," he said. "So we’ve often not included the patients in our care plans and we have not enlisted them as part of the team in their own care.”

Graham also said doctors and insurers are not doing enough to treat and prevent pre-diabetes.

“If we wanted to save money and if we wanted to make diabetes care more effective, the first thing we would do would be to stop people from becoming diabetic," he said.

Overall, Graham said the steps health care providers are taking are good ones and making these changes could lead to some problems at first. He said doctors and insurance companies will have to create a new kind of system to coordinate the services they provide to avoid redundancy.

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