Insurers keep watchful eye on costly diabetic members


Now more than ever insurers are monitoring their diabetic patients to ensure they don't miss appointments or forget to fill up prescriptions, reports the Associated Press.

The Affordable Care Act no longer allows insurance companies to charge more to diabetics. So, insurers are doing what they can to help diabetics avoid costly complications--everything from arranging transportation to the doctor's office to sending nurses on house calls, notes the AP.

Diabetes is the leading cause of heart disease, strokes, kidney failure and vision loss. About 60 percent of people with Type 2 diabetes can keep side effects at bay by simply managing sugar levels, exercising and watching their weight, WellPoint Chief Medical Officer Sam Nussbaum, a former endocrinologist at Harvard's Massachusetts General Hospital, told the AP.

UnitedHealth's Diabetes Health Plan has helped the nation's largest insurer improve the health of members with diabetes while simultaneously lowering healthcare costs, FierceHealthPayer previously reported. The program uses incentive payments to encourage participants to lose weight and get healthy.

The cost of diabetes reached an estimated $194 billion inn 2010, according to AIS Health. Covering a member without a chronic disease costs UnitedHealth about $4,400 annually. Members with diabetes who experience no complications cost $11,700, while those with diabetes and complications cost $20,700.

"But if you let any of those long-term, difficult complications develop, then you're talking $100,000 dollars plus," Nussbaum told the AP.

Meanwhile, a proposed Medicare bill could improve population health by preventing nearly 1 million cases of diabetes by 2024, according to a study released by the American Diabetes Association and the National Council of Young Men's Christian Association. The bill would provide aid for the National Diabetes Prevention Program for those diagnosed with prediabetes. The group-based based, with a 16-session lifestyle intervention program costs insurers an average of $440 per person, FierceHealthPayer previously reported.

Other insurance companies have caught on to the trend of checking on their diabetic consumers. Last fall, WellPoint held workshops to help diabetics monitor sugar levels and find emotional support, reports the AP.

For more:
- here's the Associated Press article
- read the AIS Health article

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