HARRISBURG and PITTSBURGH, Pa., Sept. 15 /PRNewswire/ -- Beginning in October 2004, HealthAmerica and HealthAssurance will join with local employers to encourage better care for diabetic patients in Pennsylvania. The health plan will provide quarterly financial rewards to practices that provide care to at least 150 diabetic members of HealthAmerica, HealthAssurance, and Advantra, and satisfy standards established by the National Committee for Quality Assurance’s Diabetes Physician Recognition Program (DPRP).
In order to receive financial incentives through the HealthAmerica and HealthAssurance Clinical Quality Incentive Program for Diabetes, or CQIPD, physicians must apply for recognition from the DPRP after satisfying the standards for quality patient care. HealthAmerica and HealthAssurance will then offer quarterly rewards of $25 to the physicians for each diabetic patient enrolled in an HealthAmerica or HealthAssurance plan. Only practices that care for at least 150 diabetic patients who are HealthAmerica or HealthAssurance members are eligible to participate in this program.
CQIPD is based on the nationwide Bridges to Excellence program, which was established by such companies as Verizon Communications, General Electric Corp., Ford Motor Co., and the United Parcel Service. The Bridges to Excellence initiative was first launched in April 2003 and is currently operating in Cincinnati, OH; Louisville, KY; Massachusetts; and the Albany- Schenectady region of New York. HealthAmerica and HealthAssurance are the first health plans to offer pay-for-performance in the central Pennsylvania region.
Francis Soistman, Jr., president and CEO of HealthAmerica and HealthAssurance, stated, “We believe that payments for care should be designed to reward providers who make positive changes to the care they provide. We are taking steps now to encourage better outcomes by implementing a process to support physicians. Physicians who provide better patient care deserve to be recognized for their commitment to quality. This new incentive program recognizes physicians for their high performance in diabetes care management.”
Jim Astuto, regional health care manager of Verizon Communications, stated, “Verizon is excited to partner with HealthAmerica and HealthAssurance in this initiative. We truly believe in providing better care for our employees, and we hope that other health plans in the central Pennsylvania region will follow HealthAmerica and HealthAssurance’s lead.”
About HealthAmerica and HealthAssurance
HealthAmerica Pennsylvania, Inc., has a 29-year record in managed care. HealthAmerica, HealthAssurance Pennsylvania, Inc., and affiliate companies cover over 730,000 members in Pennsylvania and Ohio through HMO, POS, PPO, Medicaid, and MedicareAdvantage plans. In addition, HealthAmerica earned an “Excellent” accreditation for its HMO plan and HealthAssurance earned an “Excellent” accreditation for the HealthAssurance POS by the National Committee for Quality Assurance, an independent, non-profit organization dedicated to measuring the quality of America’s health care. With corporate offices in Pittsburgh and Harrisburg, Pennsylvania, HealthAmerica and HealthAssurance provide managed health care products and services to over 11,000 employers in Pennsylvania and Ohio. For more information, visit HealthAmerica’s Web site at http://www.healthamerica.cvty.com/ .
HealthAmerica and HealthAssurance Diabetes Fact Sheet
Prevalence of total diabetes in the United States, all ages -- United States, 2002
Total: 18.2 million people -- 6.3% of the population -- have diabetes. Diagnosed: 13 million people Undiagnosed: 5.2 million people
Prevalence of total diabetes among people under 20 years of age -- United States, 2002
- About 206,000 people under 20 years of age have diabetes. This represents 0.25% of all people in this age group. - Approximately one in every 400 to 500 children and adolescents has type 1 diabetes. - Clinic-based reports and regional studies indicate that type 2 diabetes is becoming more common among Native American/American Indian, African American, and Hispanic and Latino children and adolescents. Deaths among people with diabetes -- United States, 2000 Diabetes was the sixth leading cause of death listed on U.S. death certificates in 2000. This is based on the 69,301 death certificates in which diabetes was listed as the underlying cause of death. Altogether, diabetes contributed to 213,062 deaths. Diabetes is likely to be under reported as a cause of death because many decedents with diabetes do not have the disease entered on their death certificate. Studies have found that only about 35% to 40% have it listed anywhere on the certificate and only about 10% to 15% have it listed as the underlying cause of death. Overall, the risk for death among people with diabetes is about 2 times that of people without diabetes. Complications of Diabetes in the United States Heart Disease and Stroke - Heart disease is the leading cause of diabetes-related deaths. Adults with diabetes have heart disease death rates about 2 to 4 times higher than adults without diabetes. - The risk for stroke is 2 to 4 times higher among people with diabetes. - About 65% of deaths among people with diabetes are due to heart disease and stroke. High Blood Pressure - About 73% of adults with diabetes have blood pressure greater than or equal to 130/80 millimeters of mercury (mm Hg) or use prescription medications for hypertension. Blindness - Diabetes is the leading cause of new cases of blindness among adults 20-74 years old. - Diabetic retinopathy causes from 12,000 to 24,000 new cases of blindness each year. Kidney Disease - Diabetes is the leading cause of treated end-stage renal disease, accounting for 43% of new cases. - In 2000, 41,046 people with diabetes began treatment for end-stage renal disease. - In 2000, a total of 129,183 people with diabetes underwent dialysis or kidney transplantation. Nervous System Disease - About 60% to 70% of people with diabetes have mild to severe forms of nervous system damage. The results of such damage include impaired sensation or pain in the feet or hands, slowed digestion of food in the stomach, carpal tunnel syndrome, and other nerve problems. - Severe forms of diabetic nerve disease are a major contributing cause of lower-extremity amputations. Amputations - More than 60% of nontraumatic lower-limb amputations in the United States occur among people with diabetes. - From 2000 to 2001, about 82,000 nontraumatic lower-limb amputations were performed each year among people with diabetes. Dental Disease - Periodontal or gum diseases are more common among people with diabetes than among people without diabetes. Among young adults, those with diabetes are often at twice the risk of those without diabetes. - Almost one-third of people with diabetes have severe periodontal diseases with loss of attachment of the gums to the teeth measuring 5 millimeters or more. Complications of Pregnancy - Poorly controlled diabetes before conception and during the first trimester of pregnancy can cause major birth defects in 5% to 10% of pregnancies and spontaneous abortions in 15% to 20% of pregnancies. - Poorly controlled diabetes during the second and third trimesters of pregnancy can result in excessively large babies, posing a risk to the mother and the child. Other Complications - Uncontrolled diabetes often leads to biochemical imbalances that can cause acute life-threatening events, such as diabetic ketoacidosis and hyperosmolar (nonketotic) coma. - People with diabetes are more susceptible to many other illnesses and, once they acquire these illnesses, often have worse prognoses than people without diabetes. For example, they are more likely to die with pneumonia or influenza than people who do not have diabetes. Cost of diabetes in the United States, 2002 Total (direct and indirect): $132 billion Direct medical costs: $92 billion Indirect costs: $40 billion (disability, work loss, premature mortality) General Information What is diabetes?
Diabetes is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both. Diabetes can be associated with serious complications and premature death, but people with diabetes can take steps to control the disease and lower the risk of complications.
Types of Diabetes
Type 1 diabetes was previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes. Type 1 diabetes develops when the body’s immune system destroys pancreatic beta cells, the only cells in the body that make the hormone insulin that regulates blood glucose. This form of diabetes usually strikes children and young adults, although disease onset can occur at any age. Type 1 diabetes may account for 5% to 10% of all diagnosed cases of diabetes. Risk factors for type 1 diabetes include autoimmune, genetic, and environmental factors.
Type 2 diabetes was previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes. Type 2 diabetes may account for about 90% to 95% of all diagnosed cases of diabetes. It usually begins as insulin resistance, a disorder in which the cells do not use insulin properly. As the need for insulin rises, the pancreas gradually loses its ability to produce insulin. Type 2 diabetes is associated with older age, obesity, family history of diabetes, prior history of gestational diabetes, impaired glucose tolerance, physical inactivity, and race/ethnicity. African Americans, Hispanic/Latino Americans, Native Americans, and some Asian Americans, Native Hawaiian, or other Pacific Islanders are at particularly high risk for type 2 diabetes. Type 2 diabetes is increasingly being diagnosed in children and adolescents.
Gestational diabetes is a form of glucose intolerance that is diagnosed in some women during pregnancy. Gestational diabetes occurs more frequently among African Americans, Hispanic/Latino Americans, and Native Americans. It is also more common among obese women and women with a family history of diabetes. During pregnancy, gestational diabetes requires treatment to normalize maternal blood glucose levels to avoid complications in the infant. After pregnancy, 5% to 10% of women with gestational diabetes are found to have type 2 diabetes. Women who have had gestational diabetes have a 20% to 50% chance of developing diabetes in the next 5-10 years.
Other specific types of diabetes result from specific genetic conditions (such as maturity-onset diabetes of youth), surgery, drugs, malnutrition, infections, and other illnesses. Such types of diabetes may account for 1% to 5% of all diagnosed cases of diabetes.
Treatment of Diabetes - In order to survive, people with type 1 diabetes must have insulin delivered by a pump or injections. - Many people with type 2 diabetes can control their blood glucose by following a careful diet and exercise program, losing excess weight, and taking oral medication. - Many people with diabetes also need to take medications to control their cholesterol and blood pressure. - Diabetes self-management education is an integral component of medical care. - Among adults with diagnosed diabetes, about 12% take both insulin and oral medications, 19% take insulin only, 53% take oral medications only, and 15% do not take either insulin or oral medications. Pre-diabetes: Impaired glucose tolerance and impaired fasting glucose - Pre-diabetes is a term used to distinguish people who are at increased risk of developing diabetes. People are considered to have pre-diabetes if they have impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT). Some people may have both IFG and IGT. - IFG is a condition in which the fasting blood sugar level is elevated (between 100 and 125 mg/dL after an overnight fast) but is not high enough to be classified as diabetes. - IGT is a condition in which the blood sugar level is elevated (between 140 and 199 milligrams per deciliter or mg/dL after a 2-hour oral glucose tolerance test), but not high enough to be classified as diabetes. - In a cross section of U.S. adults tested in 1988 to 1994, 33.8% of adults aged 40-74 years had IFG, 15.4% had IGT, and 40.1% had pre-diabetes (IFG or IGT or both). Were these percentages applied to the 2000 U.S. population, about 35 million adults aged 40-74 would have IFG, 16 million would have IGT and 41 million would have pre-diabetes. - Progression to diabetes among those with pre-diabetes is not inevitable. Studies suggest that weight loss and increased physical activity among people with pre-diabetes prevents or delays diabetes and may return blood glucose levels to normal. - People with pre-diabetes are already at increased risk for heart disease and stroke. Prevention or Delay of Diabetes
Research studies in the United States and abroad have found that lifestyle changes can prevent or delay the onset of type 2 diabetes among high-risk adults. These studies included people with IGT and other high-risk characteristics for developing diabetes. Lifestyle interventions included diet and moderate-intensity physical activity (such as walking for 2 1/2 hours each week). In the Diabetes Prevention Program, a large prevention study of people at high risk for diabetes, the development of diabetes was reduced 58% over three (3) years.
Studies have also shown that medications have been successful in preventing diabetes in some population groups. In the Diabetes Prevention Program, people treated with the drug metformin reduced their risk of developing diabetes by 31% over three (3) years. Treatment with metformin was most effective among younger, heavier people (those 25-40 years of age who were 50 to 80 pounds overweight) and less effective among older people and people who were not as overweight.
Similarly, in the STOP-NIDDM Trial, treatment of people with IGT with acarbose reduced the risk of developing diabetes by 25% over three (3) years. Other medication studies are ongoing. In addition to preventing progression from IGT to diabetes, both lifestyle and medication have also been shown to increase the probability of reverting from IGT to normal glucose tolerance. There are no known methods to prevent type 1 diabetes. Several clinical trials are currently in progress, and being planned.
Prevention of Diabetes Complications Glucose Control - Research studies in the United States and abroad have found that improved glycemic control benefits people with either type 1 or type 2 diabetes. In general, for every 1 point reduction in A1C, the risk of developing microvascular diabetic complications (eye, kidney and nerve disease) is reduced by up to 40%. Blood Pressure Control - Blood pressure control can reduce cardiovascular disease (heart disease and stroke) by approximately 33% to 50%, and can reduce microvascular disease (eye, kidney, and nerve disease) by approximately 33%. - In general, for every 10 mm Hg reduction in systolic blood pressure, the risk for any complication related to diabetes is reduced by 12%. Control of Blood Lipids - Improved control of cholesterol and lipids (for example, HDL, LDL, and triglycerides) can reduce cardiovascular complications by 20% to 50%. Preventive Care Pactices for Eyes, Kidneys, and Feet - Detection and treatment of diabetic eye disease with laser therapy can reduce the development of severe vision loss by an estimated 50% to 60%. - Comprehensive foot care programs can reduce amputation rates by 45% to 85%. - Detection and treatment of early diabetic kidney disease can reduce the development of kidney failure by 30% to 70%.
Reprinted with permission. American Diabetes Association. http://www.diabetes.org/diabetes-statistics/national-diabetes-fact-sheet.jsp
HealthAmerica; HealthAssurance
CONTACT: Kendall Marcocci, Director of Communications of HealthAmericaand HealthAssurance, +1-717-540-6746
Web site: http://www.healthamerica.cvty.com/
