Medicare spending increased 4.5% to $646.2B in 2015 (https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/nhe-fact-sheet.html). If the statistic holds true that “1 out of 3 Medicare dollars is spent on diabetes”, with a high proportion of that spending a result of tertiary care needed because of poor or otherwise unmanaged care, comes to about $215B (http://www.diabetes.org/diabetes-basics/statistics/infographics/adv-staggering-cost-of-diabetes.html?referrer=https://www.google.com/). What this research is offering is not only a dollar amount that can be saved because of utilizing a community health worker intervention, but an increase of health status among the Medicare and related
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The law goes on to state that, “The Secretary shall establish guidelines for assuring the quality of the training and supervision of community health workers under the programs funded under this section and for assuring the cost-effectiveness of such programs (PPACA, 2014).” By providing a cost-effectiveness analysis that includes the upfront costs per member to Medicare in the first year as well as evidence of the savings per member in the second year and on may encourage Medicare to not only utilize CHWs as a normal provision of services for not only diabetes, but other chronic conditions. This could commence a kind of domino effect influencing the health care system’s structure and other public and private payers’ decisions to implement reimbursements and/or programs that utilize CHWs and their respective services for their …show more content…
The Medicare population as of 2015 was identified as 76% White, 11% Black, 8% Hispanic and 6% were regarded as Other. Most of the literature on interventions that utilize CHWs to support patients with Type II Diabetes focuses primarily on marginalized populations. There are also varying baselines of HbA1C levels among these different populations, and because more success is usually seen with those occupying the higher levels, usually racial and ethnic minorities, the bias has been to research them specifically. This is not to say that there would not be a reduction amongst less sickly populations, even six-tenths of a percent reduction of A1C levels can equate to at least $33 worth of savings Also, although the HbA1c test is used primarily to diagnose and monitor diabetes, it can be unreliable or not usable at all in many subjects. Because the A1C test is based on the attachment of glucose to hemoglobin and Abnormal hemoglobin traits are not uncommon in many regions of the world, and they significantly interfere with A1C assay leading to spurious results(https://www.niddk.nih.gov/health-information/diabetes/diagnosis-diabetes-prediabetes/a1c-test) (10.2337/dc11-s216). Each 1 percent reduction of the A1C reduces the risk of long term complications of diabetes, including eye, kidney, heart and nerve disease, all of which would amount in additional savings visits in the clinic before or after home-based visits. This brings us to another
The law goes on to state that, “The Secretary shall establish guidelines for assuring the quality of the training and supervision of community health workers under the programs funded under this section and for assuring the cost-effectiveness of such programs (PPACA, 2014).” By providing a cost-effectiveness analysis that includes the upfront costs per member to Medicare in the first year as well as evidence of the savings per member in the second year and on may encourage Medicare to not only utilize CHWs as a normal provision of services for not only diabetes, but other chronic conditions. This could commence a kind of domino effect influencing the health care system’s structure and other public and private payers’ decisions to implement reimbursements and/or programs that utilize CHWs and their respective services for their …show more content…
The Medicare population as of 2015 was identified as 76% White, 11% Black, 8% Hispanic and 6% were regarded as Other. Most of the literature on interventions that utilize CHWs to support patients with Type II Diabetes focuses primarily on marginalized populations. There are also varying baselines of HbA1C levels among these different populations, and because more success is usually seen with those occupying the higher levels, usually racial and ethnic minorities, the bias has been to research them specifically. This is not to say that there would not be a reduction amongst less sickly populations, even six-tenths of a percent reduction of A1C levels can equate to at least $33 worth of savings Also, although the HbA1c test is used primarily to diagnose and monitor diabetes, it can be unreliable or not usable at all in many subjects. Because the A1C test is based on the attachment of glucose to hemoglobin and Abnormal hemoglobin traits are not uncommon in many regions of the world, and they significantly interfere with A1C assay leading to spurious results(https://www.niddk.nih.gov/health-information/diabetes/diagnosis-diabetes-prediabetes/a1c-test) (10.2337/dc11-s216). Each 1 percent reduction of the A1C reduces the risk of long term complications of diabetes, including eye, kidney, heart and nerve disease, all of which would amount in additional savings visits in the clinic before or after home-based visits. This brings us to another