Developed by the Lewin Group under the AHRQ Diabetes project. Interested in developing the business case to pursuing diabetes disease management. …
Diabetes Sub CFT Meeting Notes
Date: January 17, 2006
Team: Diabetes Sub CFT
Attendees:
|Members |Others |Unavailable: |
|Bala Pai |Marlene Abbott |Ken Bollin |
|Cyndy Parker |Sarah Stout - Lewin Group |Dorothy Kahkonen |
|Steve Bernstein |Deb Ebers |Bob Anderson - ad hoc |
|Nancy Sammons | | |
|Sue Moran | | |
|Jim Mortimer | | |
|Chris Bush | | |
|Julie Zvoch | | |
Bala opened the meeting with a welcome and review of the 3Ws
o Still no replacement for Ken Bollin This is being worked
o Sarah on line to talk about ROI calculator
o Julie stated that the ADA is going to try to bring a representative
from Pitney Bowes to speak in March or April She will share the
information
o Jim has another Pitney Bowes article to share with the
group Marlene
to send to group
Bala gave a review of the CFT1 meeting
o Dr Billi to request support from RITE and Steering Committee for
BMC2
o Discussed NY Times article on diabetes
Refocus to prevention activities instead of management of the
disease
Made referral to CFT 2 - Differential Payment for consideration
Chris noted they have a dietician that comes in once a month
There isnt reimbursement to cover additional services / other
professionals to provide better services Needs to be attacked at
the preventative level, ie School lunch program, exercise, etc
Cyndy - the autos dont cover preventative care except for HMO
Need to be careful about opening the classifications Once you
open for one you have to include them all
Nancy - could you get around that by offering to cover procedures,
ie Diabetes education vs RN services
Cyndy - you can but with the union when you open up for one
service it seems to expand
Deb - could you do a demonstration pilot?
Cyndy - could be done, they take a long time, too few people, but
thought we were looking at doing fast and has momentum
Marlene - the idea behind the referral to CFT 2, set an financial
incentive to develop preventive services
Bala - mentioned labor union role in project of diabetes, trained
members in diabetes and applying the knowledge
Sarah discussed the Diabetes calculator The slides were sent out to the
members
o Developed by the Lewin Group under the AHRQ Diabetes project Grew
out of a request from the MidAtlantic Business Group on Health
Interested in developing the business case to pursuing diabetes
disease management Needed something that they could use to explain to
Senior Management the value of preventative measures
o Calculator will give employer estimate of cost savings of diabetes
interventions based upon beneficiary population The 4 interventions
include- disease/care management, provider education, patient
education, and patient reminders Sarah will send Marlene the
interventions definitions Marlene will send out
o A tool is continually undergoing improvements and is sent out to
experts for review Dr Bernstein has also
reviewed the tool
o Jim stated that they had thought of offering to the employers who are
part of GDAHC to think about the opportunities/ROI
o Bala asked about the hospitals? That is where the highest cost is
o Sarah - the way it works, it doesnt address that specific of a
detail
o Marlene - put the call out to the SLSD participants and offer the
tool to see where the greatest cost savings could be
o Is this Internet based or a paper system?
o Sarah - Eventually it will be Internet based - right now it is excel
o Cyndy asked who would do the actual input?
o Marlene - employers gather the information and Sarah would run the
report
o What is the turn around time to get the calculation back?
o Sarah - making 3 modifications this week - incorporating cost of
intervention more accurately - 1 day turn around
o Marlene stated that by the time we would receive the data back from
the plans the modifications would be done and ready to be used by the
group
o Are we targeting the plans and the employers - would be duplicate data
since the same population is getting counted
o Cyndy - we
would need to have a NDA
o Marlene would like to get it both ways and see where the highest
response came from and report that information
Bala reviewed the Measurement Metrics
o What should we focus on for year 1? For HbgA1c control is the key
o If we are looking for a short-term return on investment; the return on
HbgA1c is not a short-term return The one that one would a short-
term investment would be blood pressure What is operational?
o Blood pressure would be the highest ROI, it may be the hardest to get
the data
o What about glycemic control in hospitals?
o The literature says that if we can control glycemic levels in
hospitals does appear to be a winner What perspective are you
looking at? If you are a hospital, Henry Ford for example, it will
lead to lower cost of patients in our system Which may be a lower
cost to the employer also
o Bala what should we be proposing? Agrees with blood pressure control
and lipid lowering We should prioritize and present to RITE /
Steering Committee
o What about aspirin use?
o Aspirin is a great intervention It is low cost - it is
intended as a
secondary prevention The measurement is difficult - there is no
documentation
o Marlene will be sending the 3Ws for everyone to prioritize the metrics
for short-term return on investment for cost and quality
Jim went through the Project Input slide
o Cyndy - Need to be careful with grouping these into certain buckets
Some apply to more than one bucket
o Chris - Education, counseling the patients of nutrition, exercise will
be most helpful to physicians This has to be a society change
Bala went through the Diabetes Project for Consideration slide 9
o Bala felt that Endorse unified Diabetes Evidence Based Guideline is
important
o Marlene suggested that maybe we develop a checklist of items that when
a diabetic patient comes in they run through the list to better help
the patient
o Steve stated sometimes doctors are inundated with paper It would be
helpful for the doctor to receive 1-page reports on each patient from
the health plans
o Marlene will talk to Chris off-line to discuss 3W taken
o Nancy- once you have the data what happens to it? What do you do with
it
and how do you support? There is no funding for educational
programs That is the frustration on the provider side
o Bala explained that at HAP they looked at the data sent to the PCP
Staff looked at office flow and patient flow and gave them certain
tools to help
o Cyndy stated that the important point is that without checks /
monitoring there is no incentive for them to put them in place
o Nancy spoke to immunization rates and the model that HAP used
o Cyndy - the Autos have done community health initiatives for years
o Steve thought it would be useful to share with the group - would give
great insight to the group
o Cyndy - will send to Marlene 3W taken
Marlene to send 3Ws
Next Meeting: Feb 7, 2006 8 am
Other upcoming meetings of interest:
o Steering Committee - Thursday, Mar 15
o CFT 1 - January 26
Decisions Made: none
Action Items: 3Ws in attached document
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