During Diabetes Awareness month (November) – and every month – someone is having a limb amputated due to diabetes every three-to-four minutes here in the United States. These patients often come from traditionally underserved populations, including Black and Latinx communities, that disproportionately experience the clinical and economic burdens of diabetes.
Getting ahead of rising patient risks can greatly improve quality of life and reduce the incidence of complications from diabetes, such as preventable foot ulcers. It can also help cut spending by $9,800 to $14,000 per patient each year.
America’s health plans have a major opportunity to pull back the curtain on health disparities, and take a hard look at what we can do to make preventive care a priority for all patients with diabetes.
Understanding the true size and scope of minority populations living with diabetes
Today, many analytics and risk stratification initiatives are built by using diagnosis and service codes to place individuals into defined disease buckets that end up prioritizing one disease state over the other without creating a full understanding of cause and effect.
For example, people with open diabetic foot ulcers, which often indicates poorly controlled diabetes, are more likely to experience additional issues, including being 30 times more likely to have a lower limb amputation, eight times more likely to be hospitalized for peripheral vascular disorders, and about two times more likely to be hospitalized for renal failure, congestive heart failure (CHF), pulmonary edema, chronic obstructive pulmonary disease (COPD), or a heart attack.
As a result, we think of downstream spending on cardiovascular disease as the primary cost driver – not diabetes – and allocate our dollars accordingly. That leaves the needs of the rising-risk diabetes population unaddressed and inaccurately minimizes the costs associated with this small but very high healthcare spend population.
Health plans need to gain visibility into all the costs and codes associated with diabetes care and common comorbidities, and that includes important changes like prioritizing integration of Social Determinants of Health (SDOH) data into predictive algorithms that serve the best interests of all patients.
Reframing the partnership between health plan and member
Working directly with community representatives can also help health plans understand the touch points that matter most to the people they serve. For example, faith-based groups can be ideal partners for making a big impact on education and building connections, since they are strong fellowship hubs that can host diabetes screenings, hold nutrition classes, or simply partner with health plans to reinforce the importance of making positive lifestyle choices.
Organizations like the Partners in Health and Wholeness (PHW), a multi-faith program developed by the North Carolina Council of Churches, is one such group that fosters healthy communities through events, financial support, and peer-to-peer education that reaches beyond the traditional clinical sphere of influence.
Communities as a point of connection and education
Using human-centered strategies for member-focused interactions can help to build and maintain trust, turning plans into more proactive allies that can effectively anticipate and respond to member needs.
For operational leaders, this includes creating workflows that attract and retain top member-facing talent and developing performance metrics that prioritize member satisfaction, relationship building, and problem solving.
This shift in perspective can empower staff to provide culturally aware, socioeconomically sensitive support and collaborate more closely with clinical care providers, social workers, digital health platforms, and community-based resources to ensure comprehensive care for higher-needs members.
Health plans that invest in creating pathways to connect with historically unseen populations before they become extremely ill will be crucial for containing spending, fostering better outcomes, and breaking the cycle of health disparities in underserved communities.
Health plans would be well-served to reassess how they are supporting some of their most at-risk populations, especially those living with complex diabetes. Doing so will not only improve health outcomes, but it will also put a significant dent in total costs of care for minority patients who are hit hardest by chronic diseases like diabetes
About Jon Bloom, MD, Chief Executive Officer, Podimetrics
Dr. Jon Bloom is a board-certified physician and entrepreneur with over 20 years of experience in technology development, patient monitoring, biomedical research, and health care delivery. He co-founded Podimetrics in 2011 while a student at the MIT Sloan School of Management, and he’s served as CEO ever since. Dr. Bloom was first inspired to create a solution to help prevent diabetic amputations while practicing anesthesia. He frequently treated patients who required foot amputations, and saw the pressing need for a less drastic way to prevent diabetic foot complications. He previously served as a Clinical Assistant Professor and staff anesthesiologist at the University of Pittsburgh Medical Center and as the Director of Global Medical Affairs for Covidien’s Respiratory and Monitoring Solutions division. Dr. Bloom has co-authored more than 20 peer-reviewed publications with a primary focus on health care economics and perioperative complications. He holds an MD from the University of Pittsburgh School of Medicine and completed his residency at Massachusetts General Hospital.
About Sukanya Lahiri Soderland, Chief Strategy Officer at Blue Cross Blue Shield of Massachusetts (Board of Directors, Podimetrics)
Sukanya is an impact-focused senior executive with deep knowledge of the healthcare ecosystem and expertise in innovation and digital transformation. She has spent over 20 years serving as an executive and trusted advisor to the boards and C-suites of companies across the healthcare continuum. Sukanya possesses deep insights into product design, partnership development, omni-channel consumer experience and the use of AI and advanced analytics to support business decision-making and operational redesign. She has used her unique combination of skills and experience to drive profitable growth, at scale, and improve health care affordability.