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August 29, 2007
Physicians Plus Ranks First in Dane County for Effectively Helping Diabetes Patients Manage Their Disease
Results Attributed to Innovative Chronic Illness Management Program
A recent comparison of health plan performance conducted by the National Committee for Quality Assurance (NCQA) identified Physicians Plus as a local and national leader in helping members with diabetes effectively manage their disease. Effective management means improved well-being and a reduced risk of future medical complications for Physicians Plus’ nearly 5,000 members living with diabetes. The result is welcome news to the local managed care organization that prides itself on providing innovative tools and resources to help its members live healthier. NCQA is a nonprofit organization dedicated to improving health care quality.
“Improving your health is all about understanding and making healthy lifestyle choices,” says Physicians Plus Chief Medical Officer Ron Parton, MD, MPH. “Preventing chronic conditions before they start is obviously ideal, but for those already diagnosed, knowing how to effectively manage your illness will help you enjoy the best-possible quality of life.”
Physicians Plus maintains strong, collaborative efforts with its network providers to provide comprehensive resources to diabetes patients. Several clinics in the Physicians Plus provider network were recognized by the American Diabetes Association Education Recognition Program. The diabetes management program was established in 2004 and uses personal telephone support to answer questions, coordinate preventive services and develop, implement and monitor care plans for high-risk members.
“Having someone to talk to has been very helpful,” says program participant Geno Dargenio of Madison who was diagnosed with diabetes three months ago. “If I’m doing something wrong, they’ll tell me and I can fix it.” Dargenio speaks with Physicians Plus Case Manager Sue Backes on a regular basis and says Backes helped him completely rethink his diet. “I’m Italian and accustomed to eating one big meal a day,” he says. “I learned that eating three meals a day is necessary to help me manage my blood sugar.” Dargenio was pleased to learn that he didn’t have to cut homemade cannolis from his diet but could pair a smaller portion with a big salad.
Complications of Unmanaged Diabetes
Diabetes is characterized by the body’s inability to produce or use insulin properly. According to the American Diabetes Association (ADA), 20.8 million children and adults in the United States, or approximately 7 percent of the population, have diabetes. The cause is unknown, but genetics, obesity and inactivity appear to have a role in the onset of the disease. The effects of diabetes vary, but common consequences include serious nerve and blood vessel damage leading to visual impairment, blindness, pain and weakness in feet and hands, and an increased risk for heart disease and stroke. Better management of blood sugar control to targeted levels can greatly reduce the occurrence of complications.
NCQA Measure of A1c Control
Each year, approximately 250 health plans, serving nearly 50 million people from across the nation, submit A1c results to NCQA for their members with diabetes.
The A1c test is a snapshot of a person’s average blood sugar control for the past two to three months. The results are a good indication of how well a person is managing their illness. The ADA recommends an A1c of less than 7 percent for people with diabetes. For every percent decrease in A1c, there is a 14–20 percent decrease in hospitalizations. A higher A1c, especially more than 9 percent, significantly increases a person’s risk of complications due to unmanaged diabetes.
Only 18 percent of Physicians Plus adult members with diabetes had an A1c test greater than 9 percent (or not tested), compared to the national average of more than 30 percent for health maintenance organizations and point-of-service plans. “We’re pleased the study shows we’re making progress,” says Parton. “We will continue to provide the best education, resources and support. We look forward to seeing even more improvement in the next report.”
For more information about NCQA, visit www.ncqa.org. For more information about Physicians Plus visit www.HealthyChoicesBigRewards.com.
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