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 GroupJamie L. Amaral, M.H.A.National Federation of IndependentBusinessKristen Birtwhistle, M.A. and JoseRivera, M.P.H.Stockton Kaiser Permanente MedicalCenterAmita Dasmahapatra, M.D.Merck-Medco Managed CareSaira R. Saeed, M.P.H.American Association of Health PlansSynnomon Harrell, M.B.A.United Automobile Workers UnionBarbara A. Larsen, M.P.H., R.D.Colorado Diabetes ControlProgram

Connie Crawley, M.S., R.D., L.D.University of GeorgiaWilliam Kincaid, M.D., M.P.H.United HealthcareSusan McCarthyBayer CorporationSuzanne Mercure (Chair)Harrington and ChappellJim AstutoVerizon WirelessDavid A. SettleSouthern CompanyPatricia 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 yearsSource: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.orgFeatures

• 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 2,806 4,209 10,665Est. # of Employees with Diabetes

350 228 217 795

Targeted Participation on Rate @ 35%

123 80 76 279

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