Making the Business Case for Diabetes at the Work Site

1. Making the Business Case for Diabetes at the Work Site Timothy McDonald, P.A., M.H.S.A. Co-Chair Business and Managed Care Work Group National Diabetes Education Program

2. Business and Managed Care Work Group (BMC) Role in NDEP • To increase awareness of the benefits of quality diabetes care among employers, benefits managers and managed care decision makers • To provide employers, health plans and employees with tools and information for incorporating diabetes education programs into the workplace

3. Jamie L. Amaral, M.H.A. National Federation of Independent Business Kristen Birtwhistle, M.A. and Jose Rivera, M.P.H. Stockton Kaiser Permanente Medical Center Amita Dasmahapatra, M.D. Merck-Medco Managed Care Saira R. Saeed, M.P.H. American Association of Health Plans Synnomon Harrell, M.B.A. United Automobile Workers Union Barbara A. Larsen, M.P.H., R.D. Colorado Diabetes Control Program Connie Crawley, M.S., R.D., L.D. University of Georgia William Kincaid, M.D., M.P.H. United Healthcare Susan McCarthy Bayer Corporation Suzanne Mercure (Chair) Harrington and Chappell Jim Astuto Verizon Wireless David A. Settle Southern Company Patricia R. Salber, M.D., M.B.A. General Motors/Kaiser Permanente BMC Work Group

4. We Have an Epidemic of Diabetes !

5. Cost Shifts to Workers: Increased Premiums and Cost-Sharing • Survey findings illustrate that workers are paying more • while benefits erode: • Premiums increased 12.7%, the highest increase since 1990 • Amount employees pay has risen substantially - up 27% from 2001 • Deductibles for PPO in network providers rose 37% in 2001 • More workers experienced reduced benefits versus increased • 9% of large firms (200 or more workers) eliminated retiree benefits for new hires or existing employees in the last two years Source:Kaiser Family Foundation and Health Research and Educational Trust; Sept. 2002

6. Diabetes Quality Improvement Project • 28.8% had HbA1c levels tested in the past year • 18% were > 9.5% • 58% had poor lipid control • 34.3% had poor BP control • 36.7% had not had an annual dilated eye exam • 45.2% had not had a foot exam Saabine JB et al. Ann Internal Med 2002; 136;565-574

7. Diabetesatwork.org

8. Diabetesatwork.orgFeatures • Free, easy-to-use, download, disseminate • 2 Assessment tools • Choosing a health plan • 30+ Lesson plans/fact sheets • Interactive user’s planning guide • Making a Difference: The Business Community Takes on Diabetes

9. Partners at Work

10. GM Health Services Diabetes Disease Management Pilot Program

11. GM Health Services Diabetes Disease Management Pilot Program • Free to employees, confidential and voluntary • Promotes improved quality of patient care • Improves care coordination for diabetic employees • Does not replace primary care physician (PCP) • Provides ongoing, long-term support for diabetics • in the workplace

12. GM Workplace Diabetes Pilot Program • Three plant locations with physician and nurse teams • Launched October 2002 • Integrates with existing programs • Community, health plan, disease management, health and safety, wellness • Enroll participants and family members • Engages participant’s PCP

13. GM Workplace Diabetes Pilot Program • Provides occupational medicine targeted interventions • Complete diabetes history • Physical examination • Recommended lab tests • Provides targeted interventions to volunteer participants • Access to certified diabetes education programs • Free follow-up HbA1C, lipid profiles, BP testing • Clearly outlines expectations/goals

14. Challenges and Guidelines • Management commitment • Long-term commitment • Employee privacy sacred • Measurement/evaluation • Conclusion/wrap-up

15. Diabetesatwork.org