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Diabetes Health Policy Issues

Overview

Overview

The importance of both diabetes and these comorbidities will continue to increase as the population ages. Therapies that have proven to reduce microvascular and macrovascular complications will need to be assessed in light of the newly identified comorbidities. Lifestyle change has been proven effective in preventing or delaying the onset of type 2 diabetes in high-risk individuals. Based on this, new public health approaches are emerging that may deserve monitoring at the national level. For example, the Diabetes Prevention Program research trial demonstrated that lifestyle intervention had its greatest impact in older adults and was effective in all racial and ethnic groups. Translational studies of this work have also shown that delivery of the lifestyle intervention in group settings at the community level are also effective at reducing type 2 diabetes risk. The National Diabetes Prevention Program has now been established to implement the lifestyle intervention nationwide. Another emerging issue is the effect on public health of new laboratory based criteria, such as introducing the use of A1c for diagnosis of type 2 diabetes or for recognizing high risk for type 2 diabetes. These changes may impact the number of individuals with undiagnosed diabetes and facilitate the introduction of type 2 diabetes prevention at a public health level. Several studies have suggested that process indicators such as foot exams, eye exams, and measurement of A1c may not be sensitive enough to capture all aspects of quality of care that ultimately result in reduced morbidity. New diabetes quality-of-care indicators are currently under development and may help determine whether appropriate, timely, evidence-based care is linked to risk factor reduction. In addition, the scientific evid Continue reading >>

Says Who: Who Is Involved In Policy-making Regarding Diabetes

Says Who: Who Is Involved In Policy-making Regarding Diabetes

Says Who: Who Is Involved in Policy-Making Regarding Diabetes Of all the trillions of dollars the United States spends each year, almost 30% of federal spending goes towards healthcare .Medicare and health spending occupies a huge slice of the budget pie. Time and time again, administrations make promises and pushes regarding healthcare policy-making, and promote these issues as fundamental focuses of their campaigns or terms in office. So, if trillions of our taxpayer dollars are funneled into an an area where decisions made are decisions for our future as patients or those who care, this money should be spent on representing our interests and an improved quality of life. So, who makes these decisions about medical safety, quality, and access for the diabetes and patient community? Health Policy Ideas: Where Are They Born? Any sort of government policy is formulated in order to solve a perceived issue. These issues are brought to the attention of people in policy-making and those who enact healthcare policy change largely through the voices of the constituents, or through policy-makers acting on what they think constituents want. Additionally, policy-makers push around the priority of specific policy issues due to their own party agenda, funding, reelection prospects, media, personal experience, and visibility of issues. Often, legislators, representatives, and executives forget important things such as the fact that those with and affected by pre-existing conditions are part of their constituency. They forget us in making our life-altering decisions. The main issues contested by Congress in once-prospective legislation, like the Better Care Reconciliation Act, are therefore potentially not initiated through listening to those affected by diabetes, or by patients in g Continue reading >>

Health Insurance No Guarantee For Diabetes Care In Developing Countries, Stanford Researchers Find

Health Insurance No Guarantee For Diabetes Care In Developing Countries, Stanford Researchers Find

Without good health care, diabetics run the risk of developing more problems, such as blindness, heart disease and kidney failure. Stanford researchers warn that those complications will put a greater financial strain on the patients and the developing countries where they live – a problem that can be addressed with improvements to health care and insurance systems. As incomes rise around the world, health experts expect a more troubling figure to increase as well: the number of diabetics in developing countries. In China and India – two of the world's most populous nations, both with fast-paced economies – the prevalence of diabetes is expected to double by 2025. Between 15 and 20 percent of the adult populations will develop the disease as household budgets increase, diets change to include more calories and new health problems emerge. But China, India and other developing countries are not fully prepared to deal with the rising trend of diabetes. And a growing number of diabetics aren't getting the care they need to prevent serious complications, Stanford researchers say. Even with insurance, many diabetics don't have essential medications that could help them manage their conditions. In many cases, people in developing countries are spending a great deal of their household incomes to pay for their treatment, said Jeremy Goldhaber-Fiebert, an assistant professor at the Stanford School of Medicine who led the research team. Insurance programs fail to protect "Public and private health insurance programs aren't providing sufficient protection for diabetics in many developing countries," said Goldhaber-Fiebert, a faculty member at Stanford Health Policy at the university's Freeman Spogli Institute for International Studies. "People with insurance aren't doing mark Continue reading >>

Issues

Issues

Diabetes Voice is the quarterly magazine of IDF. It covers the latest developments in diabetes care, education, prevention, research, health policy and economics, as well as themes related to living with diabetes. Diabetes Voice goes to the heart of issues that are crucial to all those who can further the promotion of diabetes care, prevention, and a cure worldwide. Editor-in-Chief: Dr Douglas Villarroel (Bolivia) Issue: April 2017 - Advancing the urgency for action The Berlin Declaration: strengthening early action for diabetes prevention and care Globally, one in 11 adults currently has diabetes (415 million people), costing health systems 12 percent of their total expenditure. By 2040, the global number of people living with diabetes is expected to rise by 227 million or 10.4 percent of the population, increasing health system costs by $129 billion.1 The effects of diabetes are well known. The condition, both directly and indirectly, is responsible for a major proportion of diabetes-related morbidity and mortality. Type 2 diabetes is one of the leading causes of cardiovascular disease, blindness, kidney failure, and lower limb amputation in many countries.2 World leaders, politicians and policy leaders can no longer afford to ignore the evidence. Our world is facing a health crisis so pervasive that it has become responsible for devastating national healthcare systems, economies, and personal lives from communities in the Northern Territories of Australia to the manic streets of Mumbai as well as the wealthy avenues of Manhattan and across the globe in cities and villages in sub-Saharan Africa where diabetes is significantly on the rise. No country or state is immune from the public health disaster of diabetes. Almost half of the total diabetes population are not aw Continue reading >>

Diabetes Health Coverage: State Laws And Programs

Diabetes Health Coverage: State Laws And Programs

Diabetes Health Coverage State Laws and Programs Diabetes Health Coverage: State Laws and Programs This is a policymaker and consumer guide to state insurance mandated coverage, Medicaid coverage and state-sponsored diabetes programs. It was published 2011and updated material was added January 2016 All state law diabetes mandates and minimum coverage requirements for state-regulated health insurance policies. The tables include the enacted state laws passedsince the firstmandates inCalifornia (1981) and New York (1993). Use links below to go directly to state-based information: State Medicaid diabetes coverage terms and conditions. All Children's Health Insurance Program (CHIP) diabetes coverage. Contact information and an overview of federal funding provided by the Centers for Disease Control and Prevention (CDC) to state-sponsored diabetes prevention and control programs (DPCPs). DPCPs represent the front line in battling diabetes in most states. An overview of other state activities and initiatives, such as creation of diabetes coordinator positions in the executive branch to fight diabetes. Federal Health Reform.The federal Affordable Care Act (ACA) signed March 2010, has led to changed and expanded coverage termed "EssentialHealth Benefits." Newly Released: NCSL Survey:Diabetes Drug coverage: A new survey of2016 Insurance Plans in 50 states, examining 1) patient access to the scores of diabetes drug treatments and2) results in the 46 states with laws mandating or offering diabetes coverage. NCSL original research, published summer 2016. [Read the report] December 2015: " Diabetes: Addressing the Costs; A 50-State Budget Survey for FY 2014 ." NCSL released its latest diabetes report, taking a closer look at programs and budget appropriations that play a role in con Continue reading >>

Policy Issues - American College Of Preventive Medicine

Policy Issues - American College Of Preventive Medicine

Overview News Issues Agenda Statements Action Center Policy Coalitions AMA House of Delegates Violence Prevention Through advocacy and government affairs, ACPM works to elevate preventive medicines voice within Congress, the Administration, and the public sphere. ACPM is active on a number of issues important to preventive medicine and advancing prevention within health systems through policy statements , op-eds, press statements, letters to Congress and the Administration, and Congressional testimony. As outlined in ACPMs Policy Agenda and Strategic Plan , ACPM plays a role in many issue areas important to our members. ACPM leads the advocacy efforts on funding for preventive medicine residency programs and pushes for greater support for population health. The college is active in the healthcare debate on repealing and replacing the Patient Protection and Affordable Care Act (ACA) and works to ensure that any new healthcare legislation includes strong public health support and access to clinical preventive services. Continue reading >>

How Health Policies Are Impacting Diabetes Diagnoses

How Health Policies Are Impacting Diabetes Diagnoses

How health policies are impacting diabetes diagnoses The Affordable Care Act (ACA), signed into law five years ago, is credited with expanding health insurance coverage in the United States, according to reports published last month by the U.S. Department of Health and Human Services and the U.S. Government Accountability Office. The data shows that 13% of American adults were uninsured in March 2015, compared to 20% when the ACAs first open-enrollment period occurred in October 2013. But lowering the number of people who are uninsured was never in and of itself the end goal of the ACA. The ACA was premised on the theory that expanded access to health insurance would facilitate greater access to health services, thereby leading to earlier detection and treatment of disease for a larger number of people. With earlier diagnosis and treatment come better health outcomes and lower costs, both for the individual and society as a whole. As a physician, an active member of the board of the American Diabetes Association Research Foundation, and a patient with Type 2 diabetes for 20 years, many of my personal and professional goals have focused on controlling diabetes, educating others, and contributing to the development of drugs to treat diabetes, one of our countrys most prevalent chronic diseases. I have been greatly influenced by the wide body of research which demonstrates that improved outcomes in diabetes care are associated with identification and intervention at the earliest, and thereby most treatable, stages of the disease. While the ACA has been the subject of five years of spirited dialogue, new evidence is emerging that suggests expanded access to care under the ACA may be having an impact on early identification of diabetes. A new study published in Diabetes Car Continue reading >>

Oecd Ilibrary | Cardiovascular Disease And Diabetes: Policies For Better Health And Quality Of Care

Oecd Ilibrary | Cardiovascular Disease And Diabetes: Policies For Better Health And Quality Of Care

Cardiovascular Disease and Diabetes: Policies for Better Health and Quality of Care This series of publications analysesthe organisation and performance ofhealth systems, andfactors explaining performance variations.Studiesare conducted on such topics asco-ordination of care, pharmaceutical pricing, long-term care and disability, healthworkforce and international migration ofhealth workers,information and communications technologies in health care, and the economics of prevention. Cardiovascular Disease and Diabetes: Policies for Better Health and Quality of Care This report examines how countries perform in their ability to prevent, manage and treat cardiovascular disease (CVD) and diabetes. The last 50 years have witnessed remarkable improvements in CVD outcomes. Since 1960, overall CVD mortality rates have fallen by over 60%, but these improvements are not evenly spread across OECD countries, and the rising prevalence of diabetes and obesity are threatening to offset gains. This report examines how OECD countries deliver the programmes and services related to CVD and diabetes. It considers how countries have used available health care resources to reduce the overall burden of CVD and diabetes, and it focuses on the variation in OECD health systems ability to convert health care inputs (such as expenditure) into health gains. Continue reading >>

The Health Insurance Landscape In The 21st Century: How Does Policy Affect People With Diabetes?

The Health Insurance Landscape In The 21st Century: How Does Policy Affect People With Diabetes?

The Health Insurance Landscape in the 21st Century: How Does Policy Affect People with Diabetes? Understanding the UnitedHealthcare/Medtronic partnership in the context of the Affordable Care Act. The diaTribe Foundation extends a big thank you to T1D Exchange, Executive Director, Dana Ball and CMO, Dr. Henry Anhalt,for organizing and hosting an important discussion on access to diabetes therapies. We have heard time and again that many patients in the US are struggling far more than they have historically with higher co-pays, higher deductibles, and higher premiums. The advent of the ACA has meant at least basic coverage for far more people but for many, if the deductible is so high, this translates into only bus coverage that means, if someone is hit by a bus, the coverage will help. Otherwise, the deductibles and associated payments are so steep that the coverage from ACA is meaningless. Some other background is also relevant. For starters, the diabetes community found out that starting on July 1, the largest insurer in the country UnitedHealthcare would designate a single manufacturer Medtronic - as its preferred provider of insulin pumps . While this affected only a small percentage of patients (the majority already used Medtronic), we like the notion of payers making decisions after they have had a chance to hear from actual patients. It is true, of course, that many decisions are already sole-source for example, Kaiser patients have used the same sole-source provider for glucose strips for well over a decade, and such agreements are common in oral drugs and insulin. Still, many patient advocates were wary of this decision by UnitedHealthcare given the very personal nature of insulin pumps. Read the letter that we wrote after a conversation with nearly two dozen Continue reading >>

Diabetes And Insurance Issues

Diabetes And Insurance Issues

When youre caring for a child with diabetes, navigating insurance issues can be a challenge. Social workers and diabetes nurses at CHOPs Diabetes Center for Children are available to help with insurance coverage and financial concerns. If you're unable to get an A1C done at CHOP: Ask your primary care doctor (PMD) if he can make a referral to CHOPs lab. If you cant get a referral to CHOPs lab, ask your primary care doctor to do an A1C a week before your diabetes visit. Make sure your PMD forwards your A1C results to your diabetes nurse or bring the results with you to your visit. If your insurance wont cover blood sugar test strips at the pharmacy: Call the Member Services phone number on your insurance card. Ask how test strips are covered. They may be covered under a Durable Medical Equipment (DME) benefit, not a pharmacy benefit. You need to get your strips, lancets and syringes through a Durable Medical Equipment supplier. Ask Member Services for DME suppliers. (You may have to make a mail order request). If you do have to pay for strips out of pocket, save your receipts. Call Member Services for help to submit them for reimbursement. If your childs insulin pens are no longer covered by insurance: Your insurance may not cover insulin pens. Insulin pens are more expensive than syringes. Many insurance companies cover the cheapest medication or device to keep costs down. Contact your diabetes nurse. She will make a request for prior authorization. She gives reasons why the insurance should cover expensive insulin pens for your child. When this works, you get a 3-6 month approval for pens. Call the insurance company yourself. Advocate for your child. Ask for a case manager to be assigned to your case so that you are talking to the same person every time. If your insur Continue reading >>

Health Plans Preventing Diabetes And Improving Well-being

Health Plans Preventing Diabetes And Improving Well-being

Health Plans Preventing Diabetes and Improving Well-Being Health Plans Preventing Diabetes And Improving Well-Being One out of every three American adults has prediabetes, and most of them do not even know it. Recent data from the Centers for Disease Control and Prevention (CDC) shows that 11 percent of people with prediabetes will develop type 2 diabetes within 3 years. To help prevent this from occurring, Americas Health Insurance Plans (AHIP) is working in collaboration with six participating health insurance plans to launch the National Diabetes Prevention Program (National DPP) in 11 states across the United States and in the U.S. Virgin Islands. The work is part of a cooperative agreement the CDC awarded to AHIP and five other organizations. Using multiple delivery models to demonstrate value and scalability, the participating health plans Anthem, Inc., Cigna Corporation, Denver Health, EmblemHealth, Florida Blue, and Health Net have launched outreach and educational efforts in California, Colorado, Florida, Illinois, Indiana, Louisiana, Massachusetts, Nebraska, New York, South Carolina, Tennessee, and the U.S. Virgin Islands. The CDC is working with community-based organizations, insurers, employers, and health care organizations to scale and sustain the National DPP across the country. CDCs role also includes ensuring a trained workforce of lifestyle coaches to lead classes effectively, as well as setting program standards and monitoring performance to recognize successful programs. Led by the CDC, the National DPP is for people at risk for developing type 2 diabetes, a serious condition that can lead to health issues including heart attack; stroke; blindness; kidney failure; or loss of toes, feet, or legs. Individuals who are 45 years of age or older, are over Continue reading >>

Advocacy Tools & Resources

Advocacy Tools & Resources

Gain information and take action to influence the future of diabetes education and the role of the diabetes educator in health care. AADE works to advance policies that support the work of the diabetes educator, reinforce the critical importance of diabetes education, and remove barriers that may affect a person with diabetes from self-managing their diabetes. We support our members as they engage in state and federal initiatives to advocate for people with diabetes and the important role of the diabetes educator in the delivery of diabetes care. Download our Advocacy Guide , which features tips on how to take action on a wide range of advocacy issues, including identifying your members of Congress and opportunities for CB involvement in advocacy. Subscribe to the Advocacy Forum on My AADE Network. Connect with advocates, find out the latest advocacy news, post your questions, and get the latest information on AADEs advocacy initiatives through our blog posts and other resources. Check out AADE's latest Advocacy Update. This details AADE's advocacy activities in the past quarter. Get help communicating the facts of DSMT with your members of Congress and find valuable resources for your State and Federal Advocacy efforts. Continue reading >>

Insurance Resources For Persons With Diabetes

Insurance Resources For Persons With Diabetes

Lack of health insurance is a major obstacle to managing diabetes. Below are links regarding options for obtaining health insurance in Texas, and frequently asked questions about diabetes equipment, supplies, medication and training that may or may not be covered by certain types of health plans. The Texas Diabetes Council does not provide or guarantee insurance coverage. It is the responsibility of the individual seeking health insurance to provide information related to eligibility and other application information to the appropriate insurance provider when seeking coverage. External links to other sites are intended to be informational and do not have the endorsement of the Texas Department of State Health Services. These sites may not be accessible to persons with disabilities. Texas Health Options Consumer information from the Texas Department of Insurance about finding group coverage, determining whether you qualify for Medicaid or Medicare, applying for coverage through the Texas Health Insurance Pool, or buying an individual policy. Includes information about plans available through the federal health insurance marketplace (www.HealthCare.gov). Texas Medicaid Site provides a list of Medicaid services in Texas, including eligibility criteria. Medicaid is the State and Federal cooperative venture that provides medical coverage to eligible needy persons. Texas Children’s Health Insurance Program (CHIP): The Children’s Health Insurance Program (CHIP) is a national program designed for families who earn too much money to qualify for Medicaid, yet cannot afford commercial insurance. Coverage is available for qualified children from birth through age 19). Medicare Formerly the Health Care Financing Administration (HCFA), now the Centers for Medicare & Medicaid Serv Continue reading >>

Denying Health Care To Diabetics Makes Just About Zero Sense

Denying Health Care To Diabetics Makes Just About Zero Sense

Denying Health Care to Diabetics Makes Just About Zero Sense Denying Health Care to Diabetics Makes Just About Zero Sense Denying Health Care to Diabetics Makes Just About Zero Sense Last week, the Trump administration made a new enemy: the American Diabetes Association. During a panel discussion at a forum for health care luminaries at Stanford University on Thursday, Trumps budget director Mick Mulvaney told an audience that the GOP bill to repeal the Affordable Care Act would take care of people with pre-existing conditions, but only to an extent. It doesnt mean we should be required to take care of the person who sits home, drinks sugary drinks, doesnt exercise, eats poorly, and gets diabetes, he said. Diabetes affects nearly 30 million Americans, most of whom did not take kindly to the jab. Almost immediately, they took to Twitter to explain that both kinds of diabetestype 1 and type 2are the result of a both genetic and environmental factors. The ADA backed them up on Friday with a public statement decrying the notion that diabetes is a disease of choice: Mr. Mulvaneys comments perpetuate the stigma that one chooses to have diabetes based on his/her lifestyle. We are also deeply troubled by his assertion that access to health care should be rationed or denied to anyone. Even if you subscribe to the notion that denying people health care is a morally acceptable way to get them to exercise or start eating better, there are still a few big problems with Mulvaneys assertion. The first is an issue of biology: You dont get diabetes by sitting around eating too much sugar. Yes, obesity is the single biggest risk factor for type 2 diabetes (the form of the disease where the body is resistant to insulin), but the research shows it takes a combination of factors to develop Continue reading >>

Health Policy And Diabetes Care: Is It Time To Put Politics Aside?

Health Policy And Diabetes Care: Is It Time To Put Politics Aside?

Health Policy and Diabetes Care: Is It Time to Put Politics Aside? 1Department of Internal Medicine, Division of Metabolism, Endocrinology & Diabetes, University of Michigan, Ann Arbor, MI 2Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA Author information Copyright and License information Disclaimer Copyright 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See " Surge in newly identified diabetes among medicaid patients in 2014 within medicaid expansion States under the affordable care act. " onpage833. This article has been cited by other articles in PMC. The burden of chronic diseases is enormous and growing, not only in the U.S. but also around the world. The control of chronic diseases requires effective approaches, including patient education, provider knowledge, and team care. Effective policies must also be enacted to address chronic diseases at a local, state, and federal level. This is especially true with regard to diabetes, which in the U.S. cost $245 billion in 2012 and consumed 1 in every 10 health care dollars ( 1 ). The current trajectory for economic costs for the U.S. is not sustainable perhaps the time is right to reevaluate our health policies. Implementing policies to prevent or treat a disease is clearly not a trivial matter, and such efforts seem to be more effective when there are specific goals. Childhood immunizations provide a good example. In the 1990s, half of the children in this country were not appropriately immunized against communicable diseases ( 2 ). As was elegantly summarized ( 2 ), It took strong evidence and a powerful political and organizational movement to get Continue reading >>

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