A Collaborative Approach for Patients with Diabetes

By California Health Policy Strategies, LLC

California Health Policy Strategies, LLC, January 18, 2018

As front-line health care providers, optometrists are seeing alarming increases in the prevalence of diabetes among their patients. In response, the California Optometric Association (COA) has spearheaded a statewide effort to improve prevention, early intervention and treatment of this deadly disease.

Medi-Cal Managed Care Plans. Lower income individuals have significantly higher incidence of diabetes, but most low-income Californians are now covered by Medi-Cal managed care plans. CalHPS conducted an analysis of these plans and ranked them based on their HEDIS scores related to diabetes care.

The CalHPS analysis has helped to foster innovative partnerships with health plans, community health clinics and optometrists to improve diabetes HEDIS scores and patient care. Anthem Blue Cross, for example, has sponsored “Diabetes Clinic Days” in Sacramento and Fresno. In this model approach, outreach workers contacted Anthem Blue Cross patients who had previously been diagnosed with diabetes but had not received a follow-up check or care for some time. Patients were scheduled for visits at local clinics, and offered free transportation. Those who came in received “one stop-shop” comprehensive diabetes screenings, needed eye exams, and other health care services.

Other health plans are now developing their own initiatives in other parts of the state.

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Medicare Advantage Patients.
CalHPS analyzed data from the California Office of the Patient Advocate and Integrated Health Care Association (IHA) to compare medical groups serving patients enrolled in Medicare Advantage plans in California. Our report looked at diabetes related quality scores for 171 different medical groups and ranked them. Based on this work, CalHPS is now reaching out to medical groups and the California Association of Physician Groups (CAPG) to explore potential collaborations to improve diabetes care.