Blunt praises pilot diabetes program

Program results show better management of disease by patients.
Wednesday, April 13, 2005 | 12:00 a.m. CDT; updated 2:01 a.m. CDT, Saturday, July 19, 2008

Diabetes patients given special instructions and feedback under a statewide pilot program better managed their blood-sugar levels and lowered their cholesterol, according to results released Tuesday.

Gov. Matt Blunt praised the program, saying these types of preventative efforts for chronic illnesses could save the state millions in Medicaid costs.

“By increasing the efficiency of health care and helping Missourians with these long-term illnesses manage their conditions, we can improve their health and reduce costs for patients and, in some cases, obviously reduce costs for Missouri taxpayers,” Blunt said Tuesday in Columbia at a conference on chronic disease.

In an effort to cut Medicaid costs, the Department of Social Services will seek bids next month from private companies to help improve treatment of Medicaid patients with chronic illness such as diabetes, asthma and depression, said George Oestreich, director of the pharmacy program for the department’s division of medical services. These companies would help the state identify Medicaid patients with the most serious chronic illnesses and ensure there are community services available to help them.

The state also plans to continue the diabetes pilot program for another year.

The emphasis on preventative treatment comes after the Legislature last week sent the governor a bill that would authorize many of Blunt’s proposed eligibility cuts to Medicaid. Republicans, including Blunt, say the Medicaid cuts are needed to balance a budget that increases school funding without seeking higher taxes.

Blunt’s proposed budget for the 2006 fiscal year relies on $15 million in savings from improved treatment of patients with chronic illnesses. He cited a recently developed chronic disease program in Florida that saved the state an estimated $42 million in Medicaid costs during its first two years.

The diabetes project began one year ago and involved 14 hospitals, 168 physicians and at least 5,000 patients statewide. The state Department of Health and Senior Services teamed up with Primaris, a nonprofit organization focused on improving state Medicaid programs, to coordinate the diabetes project.

It focused on encouraging health care providers to give diabetes patients additional education, feedback and support to better control their disease. Some providers established support groups for participants while others gave report cards to patients measuring how well they were managing their diabetes, said Andrew Shea, spokesman for Primaris.

Since the program began, Shea said the percentage of diabetic patients with appropriate blood sugar levels increased by almost 60 percent. That number is significant, Shea said, because for every 1 percent drop in blood glucose levels, the risk of patients developing eye disease, kidney disease, or the need to amputate a leg or foot drops by 40 percent.

The program also found that overall cholesterol levels for patients dropped by nearly 7 percentage points and that 7 percent of patients quit smoking. Health providers were also able to refer more than 1,200 patients overdue for a retinal exam to an eye specialist.

Dr. William Kincaid, chair of the St. Louis Diabetes Coalition, said the program’s success illustrates that empowering the patient is the key to treating chronic illnesses.

“The patient has to be a much better partner in treating their own disease and they need to take the leadership role in dealing with that,” Kincaid said. “The physician can prescribe the medicine but unless the patient eats correctly, takes their medicines on time and keeps their cholesterol levels down, get their blood sugars down, they are not going to be healthy in the long run.”

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