Diabetes Awareness: Good for Star Ratings

Nov 21, 2014
Supporting diabetes awareness can aid star ratings performance.
  • Medicare
  • Diabetes

Health outcomes for beneficiaries with diabetes can have an exponential impact on a Medicare plan’s quality measures and star ratings performance making it one of the most important therapeutic categories to manage.

However, to improve their health outcomes, beneficiaries with diabetes must take an active role in managing their disease, remaining adherent with therapy, maintaining A1C levels within acceptable ranges, keeping up with cholesterol screenings, and using appropriate hypertension and cholesterol therapies.

In support of Diabetes Awareness Month, here are a few important ways Medicare plans can support beneficiaries to help them better manage their condition and positively impact their quality measures and star ratings performance.

Communicate and Engage

Plans that go beyond simple disease education – and make diabetes awareness a yearlong endeavor – can make a positive impact on the way they connect with beneficiaries. Use social media channels to connect with members and their caregivers every day. These quick educational opportunities can focus on medication adherence, offer advice to patients about their condition and encourage positive behaviors. For most Medicare plans, this remains a largely untapped opportunity to interact with members. As more baby boomers age into Medicare, we see social media becoming more widely used.

Make Adherence Easy

We know humans aren’t necessarily wired to take medication as prescribed. When caring for the Medicare population, adherence is further complicated by a beneficiary’s ability to get to a pharmacy for their prescription or to a lab for a screening. Making these tasks easier for members can go a long way in improving adherence with therapy and treatment guidelines. 

In fact, a recent study published in the Journal of Managed Care Pharmacy concluded Medicare beneficiaries who received medication for diabetes, high blood pressure and high cholesterol through the Express Scripts PharmacySM are 25% to 29% more likely to be adherent with their prescription therapy than patients with these conditions who fill prescriptions at a retail pharmacy.

Also, offering members tips for remembering to take their medications improves adherence. Encouraging members to link an already daily routine with taking medication will boost adherence. For example, putting a pill box next to your toothbrush will help remind you to take your medications after brushing your teeth.

Did you know? Medicare beneficiaries taking diabetes, high blood pressure and high cholesterol medications through the Express Scripts PharmacySM are 25% to 29% more likely to be adherent.

Involve a Specialist

In addition to a primary care physician, diabetes patients may need to receive specialist physician care, such as an endocrinologist, to more effectively manage their disease. The same can be applied to pharmacy care. Specialist pharmacists in the Express Scripts Diabetes Therapeutic Resource Center® have advanced knowledge about diabetes therapy and “muscle memory” from repeated experience helping to coach, support and respond to questions and concerns from members with diabetes. Also, these pharmacists are better equipped to quickly identify gaps in care – such as the absence of statin therapy or cholesterol screenings – and can counsel and support patients in the privacy of their homes through telephone conversations.

A recent J.D. Power survey showed patients who speak with an Express Scripts specialist pharmacist converse for an average of 12 minutes, whereas a patient speaking with a retail pharmacist converses for fewer than two minutes.

Better Decisions Leads to Healthier Outcomes

There has never been a more important time for plans to help their members with diabetes – and those who care for them – achieve the best possible health outcomes. Plans that encourage beneficiaries to take an active role in managing their disease and make healthy decisions will see a significant improvement in patient outcomes and plan performance.

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