House Health Reform Bill Heavy on Prevention

Monday, November 9th, 2009
This post was written by Melanie Matthews

The health reform bill that passed by a slim margin in the House on Saturday is still a long way from being law. However, it’s worth noting the bill’s huge focus on “high-value healthcare,” defined in the House bill as “the efficient delivery of high quality, evidence-based, patient-centered care.” The word “value” is mentioned 112 times in the 1,990-page document. Getting more ink is “prevention,” which appears 226 times — as in diabetes prevention, obesity prevention, prevention of alcohol and substance abuse, suicide prevention, and many other programs aimed at improving the overall health status of the nation.

Speaking of health status, Mississippi has one of the nation’s highest obesity rates, along with high rates of diabetes, poverty and medical need. The Mississippi Health First Collaborative announced last week by CMS wants to change those statistics by improving care for patients with diabetes in that state. The non-traditional approach profiled in this issue of the Healthcare Business Weekly Update will deliver diabetes self-management education in community centers and senior centers instead of the usual healthcare settings. Partnering in the collaborative are community groups, health experts, faith-based organizations, housing providers, healthcare providers and others to reach the insured and uninsured across the state.

Poorly managed, uncontrolled diabetes leads to many serious and costly complications. Health First can learn a great deal from Community Care Plan of Eastern North Carolina, which began establishing medical homes for diabetics in its Medicaid population in 2000. Case managers embedded in primary practices called enrollees, sent out information on community support groups, diabetes health fairs and medications — even went to patients’ homes and taught them one-on-one how to test glucose levels and do a foot exam. An external program evaluation by the Cecil G. Sheps Center for Health Services Research estimated a $2.1 million savings from that diabetes program.

In a recent podcast, Community’s nurse case manager Roberta Burgess described the provider and patient education aspects of the diabetes medical home program.

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