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Diabetes Coordination Program a Lesson in Rural Innovation

John Commins, for HealthLeaders Media, February 29, 2012

John R. Strube, CCHS's vice president of marketing and development, told HealthLeaders Media that most of the grant money will pay for two fulltime nurse coordinators to aggressively monitor treatment regimens for about 250 patients "whose A1Cs are seriously out of control."

"Diabetes is one of those illnesses that if you manage it well, you prevent a lot of damaging and expensive health problems, because the disease really does attack your whole system," Strube explained. "One of the challenges particularly for folks in the safety-net world or folks who have limited coverage is getting them involved in the kind of really intensive care you need to manage or prevent diabetes."

"The opportunity from CareFirst was particularly intriguing for us because they are focusing on doing things at the primary care level to manage chronic and multi-symptom diseases effectively and at a more cost-effective point in the care delivery system than having folks show up in the hospital in severe shape."

In addition to the individualized treatment plans and close monitoring, the intervention program will use group-centered disease management tactics that rely on peer support to maintain treatment regimens.

"Most insurance companies don't cover that very well but we made it clear to CareFirst that if this model works would you consider adapting your reimbursement model to cover this? They said yes," Strube says. "There is a real excitement about the partnership we are building."

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1 comments on "Diabetes Coordination Program a Lesson in Rural Innovation"


Laura S. Morris (3/1/2012 at 2:32 PM)
We did this using community-based patient navigators under the new federal Patient Navigator Demonstration Program. Unfortunately we were not able to sustain it when the grant ended as no single provider was able to "own" and show an immediate return the community investment. Until there is a reimbursement for care coordination or providers are given a financial encentive, this proven concept for dealing with chronic diseases will go wanting.