The Role of Physicians and Care Teams in Preventing Diabetes

Transcription

1 The Role of Physicians and Care Teams in Preventing Diabetes Karen Kmetik, PhD Group Vice President, Improving Health Outcomes American Medical Association (AMA) February 25, 2016

2 Outline Conversations with physicians and care teams regarding prevention AMA experience Resources available to support physicians, care teams and the patients you serve 2

3 Chronic disease impact on clinical practice 3

4 Diabetes impact on clinical practice Over the next 5 years, a typical large clinical practice could experience a 57% increase in the number of patients with type 2 diabetes 15,000 16,750 18,483 20,198 21,896 23, Based on a panel size of approximately 100,000 patients Slide courtesy of Ronald T. Ackermann, MD, MPH, Northwestern University Feinberg School of Medicine 4

5 Value based payment models As part of accelerating the shift to value-based payment, CMS and major commercial health plans, in concert with physician groups and other stakeholders, announce[d] alignment and simplification of quality measures including identifying preventive diabetes measures. This is a significant step towards prioritizing diabetes prevention for value based payments, both for coverage and to drive accountability for improved health outcomes.*** * Better, Smarter, Healthier: In historic announcement, HHS sets clear goals and timeline for shifting Medicare reimbursements from volume to value. HHS.gov2015. Available at: Accessed February 18, ** Evans M, Herman B. Where healthcare is now on march to value-based pay.modern Healthcare 2015 *** CMS and major commercial health plans, in concert with physician groups and other stakeholders, announce alignment and simplification of quality measures Available at: Accessed February 18,

6 Factors affecting outcomes The future health ecosystem will focus on the true drivers of outcomes Health Behaviors 30% Physician Influence National DPP Clinical Care 20% Physical Environment 10% Social & Economic Factors 40% 6

7 USPSTF screening recommendations Population Recommendation Grade: B Risk Assessment Screening Tests Adults aged 40 to 70 years who are overweight or obese Screen for abnormal blood glucose. Offer or refer patients with abnormal glucose to intensive behavioral counseling interventions to promote a healthful diet and physical activity. Risk factors include overweight and obesity or a high percentage of abdominal fat, physical inactivity and smoking. Hemoglobin A1c or fasting plasma glucose or an oral glucose tolerance test. 7

8 Effectiveness of medication vs. lifestyle change program 60% 58% Impact (Reduced Risk of Diabetes Over 3 Years) 30% 31% Glucose Lowering Drug Reduced Calorie and Low Fat Diet Consistent Walking Program Even greater risk reduction (71%) among adults 60 years and older Metformin Lifestyle *Knowler WC, Barrett-Connor E, Fowler SE, et al. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):

9 AMA collaboration with Y-USA (CMMI award) AZ DE FL IN MN NY OH TX Engaged over 500 physicians and care teams Connect clinical practices with local YMCA-based programs Support clinical practices with screening, testing and referral 9

10 Systems approach: AMA working with physicians and teams Query the EHR to find patients Deliver a clear message: Prediabetes is a condition and it s reversible Make clinic-community (virtual) linkage Refer patients to a National DPP Support patients throughout lifestyle change program 10

11 American Medical Association. All rights reserved. 11

12 National multi-year prediabetes ad campaign Simultaneous communications efforts are in progress and targeted at physicians and their care teams. Goal: Ensure they are prepared for conversations with their patients by accessing tools and resources developed jointly by the AMA and CDC Stresses importance of prediabetes. Encourages screening, testing and referring to DPP Ensures patients are informed

13 It is imperative that we promote an intervention that is known to be cost-effective, improves health, reduces the need for medication, and has the potential to enable millions of Americans to evade a remaining lifetime burdened by the daily management of diabetes. Ron Ackerman, MD 13