Transcript Cost Shifts to Workers: Increased Premiums and Cost

Making the Business Case for
Diabetes at the Work Site
Timothy McDonald, P.A., M.H.S.A.
Co-Chair
Business and Managed Care Work Group
National Diabetes Education Program
Business and Managed Care
Work Group (BMC)
Role in NDEP
• To increase awareness of the benefits of quality diabetes
care among employers, benefits managers and managed
care decision makers
• To provide employers, health plans and employees with
tools and information for incorporating diabetes education
programs into the workplace
BMC Work Group
Jamie L. Amaral, M.H.A.
National Federation of Independent
Business
Kristen Birtwhistle, M.A. and Jose
Rivera, M.P.H.
Stockton Kaiser Permanente Medical
Center
Amita Dasmahapatra, M.D.
Merck-Medco Managed Care
Saira R. Saeed, M.P.H.
American Association of Health Plans
Synnomon Harrell, M.B.A.
United Automobile Workers Union
Barbara A. Larsen, M.P.H., R.D.
Colorado Diabetes Control
Program
Connie Crawley, M.S., R.D.,
L.D.
University of Georgia
William Kincaid, M.D., M.P.H.
United Healthcare
Susan McCarthy
Bayer Corporation
Suzanne Mercure (Chair)
Harrington and Chappell
Jim Astuto
Verizon Wireless
David A. Settle
Southern Company
Patricia R. Salber, M.D.,
M.B.A.
General Motors/Kaiser
Permanente
We Have an Epidemic of
Diabetes !
Cost Shifts to Workers: Increased
Premiums and Cost-Sharing
Survey findings illustrate that workers are paying more
while benefits erode:
Premiums increased 12.7%, the highest increase since 1990
 Amount employees pay has risen substantially - up 27% from 2001
 Deductibles for PPO in network providers rose 37% in 2001
 More workers experienced reduced benefits versus increased
 9% of large firms (200 or more workers) eliminated retiree
benefits for new hires or existing employees in the last two years
Source:Kaiser Family Foundation and Health Research and Educational Trust; Sept. 2002
Diabetes Quality Improvement
Project
• 28.8% had HbA1c levels tested in the past year
– 18% were > 9.5%
• 58% had poor lipid control
• 34.3% had poor BP control
• 36.7% had not had an annual dilated eye exam
• 45.2% had not had a foot exam
Saabine JB et al. Ann Internal Med 2002; 136;565-574
Diabetesatwork.org
Diabetesatwork.org
Features
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Free, easy-to-use, download, disseminate
2 Assessment tools
Choosing a health plan
30+ Lesson plans/fact sheets
Interactive user’s planning guide
Making a Difference: The Business
Community Takes on Diabetes
Partners at Work
GM Health Services Diabetes Disease
Management Pilot Program
Eligible
Members
GMPT
Flint North
MFD
Parma
Moraine
Assembly
Total
Active Hourly
Employees
3,650
2,570
3,960
10,180
Active
Salaried
Employees
0
236
249
485
Total
3,650
350
2,806
228
4,209
217
10,665
795
123
80
76
279
Est. # of
Employees
with Diabetes
Targeted
Participation
on Rate @
35%
GM Health Services Diabetes Disease
Management Pilot Program
•Free to employees, confidential and voluntary
•Promotes improved quality of patient care
•Improves care coordination for diabetic employees
•Does not replace primary care physician (PCP)
•Provides ongoing, long-term support for diabetics
in the workplace
GM Workplace Diabetes Pilot
Program
• Three plant locations with physician and nurse teams
– Launched October 2002
• Integrates with existing programs
– Community, health plan, disease management, health
and safety, wellness
– Enroll participants and family members
• Engages participant’s PCP
GM Workplace Diabetes Pilot Program
• Provides occupational medicine targeted
interventions
– Complete diabetes history
– Physical examination
– Recommended lab tests
• Provides targeted interventions to volunteer
participants
– Access to certified diabetes education programs
– Free follow-up HbA1C, lipid profiles, BP testing
• Clearly outlines expectations/goals
Challenges and Guidelines
• Management commitment
• Long-term commitment
• Employee privacy sacred
• Measurement/evaluation
• Conclusion/wrap-up
Diabetesatwork.org