iLoveBenefits: Industry News Blog

Diabetes Spending Reached $16,021 Per Capita in 2014

The Health Cost Institute recently released a study on healthcare spending for diabetes patients. Here are some key findings from the report:

  • Spending on people with diabetes reached $16,021 per capita in 2014, an $897 increase from 2013.
  • Health care spending for people with diabetes rose 6% compared to 3.2% for people without diabetes.
  • The number of ER visits among people with diabetes rose 8.1% annually from 2012-2014.
  • People with diabetes had 7x more filled days of cardiovascular drugs than those without diabetes.
  • Young adults (19-25) with diabetes had 4x more hospital admissions for mental health and substance use.
  • In 2014, insureds with diabetes spent $1,944 out of pocket compared to $752 for those without diabetes.

Source: Health Cost Institute, June 20, 2016

Hospital at Home model gains steam

Hospital at Home model gains steam as Mt. Sinai program cuts costs, readmissions

Monday, June 6, 2016 | By Zack Budryk

Cutting readmissions and reducing medical errors, the nation’s third-leading cause of death, are among the healthcare industry’s top priorities, and the secret to solving both may be stepping up home care, according to Oregon Public Broadcasting.

Nearly two years ago, New York’s Mt. Sinai Hospital premiered the Mobile Acute Care Team (MACT) program. This pilot program aims to deliver hospital-quality home care for patients who are at high risk for readmission. So far, the ongoing pilot has cut costs by nearly 20 percent, according to the article, while also reducing an unspecified percentage of readmissions and delivering high patient satisfaction.

Under the program, Mt. Sinai partners with community institutions such as Visiting Nurse Service of New York to provide home treatment for such conditions as chronic obstructive pulmonary disease (COPD), congestive heart failure, diabetes and urinary tract infections, according to a blog post from the hospital. “This is a real paradigm shift in medicine,” Mt. Sinai’s Linda DeCherrie, M.D., told OPB.  People will often say on first glance, ‘That sounds so great that we should definitely do that,’ but when you really get into it, it’s a totally different way of providing care.”

Medicare’s refusal to cover hospital-at-home services has kept many such programs from getting off the ground, but the Center for Medicaid & Medicaid Services’ Innovation Center awarded the MACT project $9.6 million in 2014 as part of its second round of Health Care Innovation Awards.

Nor is the MACT program the only example of such a program working; an internal analysis of the Humana At Home care management service found it cut hospitalizations among participants 45 percent while boosting survival rates, according toOpen Minds. Those Hospital at Home programs that have demonstrated consistent success have been connected to primary- and palliative care programs as well as disease-management programsFierceHealthcare previously reported.

To learn more: – read the OPB article – here’s the Mt. Sinai blog post – read the CMS announcement – check out the Open Minds post

Related Articles: How to make Hospital at Home programs work How transitional care cuts readmission risk First Medicare-approved transitional care center opens for business Readmission reduction solution: House calls How hospital-community partnerships can boost population health ER overcrowding solution: Community paramedicine

Diabetes awareness

The CDC and doctors team up for a diabetes initiative. With 90 percent of people who have pre-diabetes unaware that they even have the condition, the Centers for Disease Control and Prevention and the American Medical Association are calling on doctors to ramp up screening efforts and raise awareness about the risk factors for developing a full onset of the disease.

The uninsured rate is falling . . . can we do the same with prices

The uninsured rate among adults in the U.S. for the fourth quarter of 2014 averaged 12.9%, compared to an uninsured rate of 17.1% for the same period one year ago, according to Gallup. Source: “In U.S., Uninsured Rate Sinks to 12.9%,” Gallup.com, January 7, 2015, http://www.gallup.com/poll/180425/uninsured-rate-sinks.aspx

Most adjusted death rates continue to fall

From 2011 to 2012, the age-adjusted death rate fell 1.8% for heart disease, 1.5% for cancer, 2.4% for chronic lower respiratory diseases, 2.6% for stroke, 3.6% for Alzheimer’s disease, 1.9% for diabetes, 8.3% for influenza and pneumonia, and 2.2% for kidney disease; but the rate for suicide rose 2.4%; and the rate for unintentional injuries remained the same. Source: “Mortality in the United States, 2012,” Centers for Disease Control and Prevention, NCHS Data Brief #168, October 2014, http://www.cdc.gov/nchs/data/databriefs/db168.htm

Screening everyone for diabetes over age 45… is that really necessary

Generally, people will get a glucose screen sometime in their lives, however, is this an appropriate strategy…telling EVERYONE after age 45 to get tested? Is this economically viable? Should there be other risk factors included in the analysis of whether to get a screening, just as they are those under 45?

USPSTF recommends wider diabetes screening in draft statement Draft recommendations from the U.S. Preventive Services Task Force call for diabetes and blood glucose screening for people 45 and older and younger adults with risk factors. The guidelines, updated from 2008, are similar to those made by other medical groups and include recommendations for diet and exercise interventions for at-risk patients. Medscape (free registration) (10/6)

No Legacy Effect for Tight Sugar Control

VIENNA — Tight glycemic control didn’t reduce mortality or major cardiovascular events in long-term follow-up of the ADVANCE study, researchers reported here. Read more

What are the benefits and challenges of long term drug utilization

While these studies demonstrate that there are benefits and challenges for statin users, it points out something that may be a very important finding. That is, that this drug (and can we extrapolate for other drugs as well) there is the potential that a drug, or combination of drugs, can advance the expression of other chronic diseases?

Statins’ heart benefits greatly exceed risks, analysis showsA review of data from studies published over the past 20 years found that the cardiovascular benefits of long-term statin use significantly outweigh the risks. Long-term use of the drugs, however, may slightly increase the risk of developing type 2 diabetes among those with existing risk factors. The findings appear in the British Medical Journal. HealthDay News (8/5)

Imagine what could have been in heart disease, if not for diabetes and obesity

Seniors are having fewer heart attacks, data showA Yale University study showed stable hospitalization rates for heart attacks among young and middle-aged adults from 2001 to 2010, while heart attack rates for Medicare-age adults dropped by more than 20%. The study in the Journal of the American College of Cardiology found women ages 30 to 54 who were hospitalized for a heart attack had a higher risk of poorer outcomes than men, and lead author Aakriti Gupta, M.D., suggested primary prevention resources should be redirected toward young women. HealthDay News (7/21)

In addition, the study points out, “Obesity and diabetes among younger adults appear to be overwhelming the improvements in treating high blood pressure and high cholesterol that have helped older Americans reduce their heart attack risk.”

Changing the paradigm and reach of the traditional office practice

Nurse-led protocol tied to better chronic disease managementAn analysis found nurse-led outpatient disease management protocols were associated with significant improvements in HbA1C, systolic blood pressure and lipid levels in patients with diabetes, hypertension and hyperlipidemia. The nurses followed a protocol for medication titration, according to the study reported in the Annals of Internal Medicine. Renal and Urology News (7/18)

Doctors agree that PAs, NPs improve care, productivityA Jackson Healthcare survey revealed about 75% of doctors who employed advance-practice professionals such as physician assistants and nurse practitioners said doing so helped improve patient care and practice efficiency, while two-thirds reported that PAs and NPs are handling tasks that formerly were handled by doctors. Sixty percent of respondents perceived the increasing role of PAs and NPs positively, researchers said. Nurse.com (7/17)

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