Improving Hypertension _ Diabetes Control and Prevention
  
An e-NEWSLETTER from Quality Insights                                                                               December 13, 2017
diabetes
get the low-down on prediabetes testing   

Screening involves the testing of asymptomatic, high-risk individuals to assess whether they meet the criteria for either prediabetes or type 2 diabetes. Screening recommendations have been made by different groups, including the American Diabetes Association and the United States Preventive Services Task Force. Although these recommendations sometimes advise screening for slightly different groups of individuals, all of them advise the use of one or more blood tests to determine the degree of blood glucose elevation.

Electronic health records (EHRs) can alert health care team members about patients who should be targeted for diabetes screening, either during or between visits to the clinic. Click here to read more, or contact  Ashley Biscardi  for assistance in setting up your clinical decision support for prediabetes screening in your EHR.
Do's and Don'ts for the Initial Patient Conversation Regarding Prediabetes 

If a patient has been identified as having prediabetes, the leader of the healthcare team (physician, nurse practitioner, or physician assistant) should engage the patient in a discussion about the diagnosis. Click here  to access the recommended Do's and Don'ts for this initial prediabetes patient encounter.
Prevent Diabetes STAT initiative aims to prevent type 2 diabetes   

The Centers for Disease Control and Prevention (CDC) and the American Medical Association (AMA) are sounding an alarm about prediabetes through a national effort called  Prevent Diabetes STAT (Screen/Test/Act/Today) . This initiative requires everyone from physicians, to employers, to patients, to community organizations, to prevent type 2 diabetes in the United States.

In addition to focusing on the person with prediabetes or diabetes, we also must engage the systems and communities where people live, work and play. Together we can make a difference. 

For tips and tools to support this effort, visit the Prevent Diabetes STAT website.
4 Strategies to Stop the Progression from Prediabetes to Diabetes   
The progression from prediabetes to diabetes can take as little as five years. During that window of time, patients can benefit from a proven intervention that is part of the CDC's National Diabetes Prevention Program (DPP). Counsel your patients that prediabetes is a potentially reversible condition and is one that you can help them manage.

Below are some strategies healthcare providers can employ to stop the progression of prediabetes advancing to diabetes:
  1. Screening and identifying patients for prediabetes;
  2. Referring them to a program that is part of the CDC's National DPP;
  3. Distributing the Know Your Numbers flyer to patients; and
  4. Making patient risk assessments, such as the Type 2 Diabetes Risk Screening Quiz or the online Type 2 Diabetes Risk Assessment, available to patients in your practice's waiting areas and exam rooms.
Click here to access the M.A.P. (Measure, Act, Partner) guidelines to Prevent Type 2 Diabetes.
learn more about Reimbursement and Coding for Prediabetes Screening

coding Medicare recommends and provides coverage for diabetes screening tests through Part B Preventive Services for beneficiaries at risk for diabetes or those diagnosed with prediabetes. For more about preventive services, see Medicare's Preventive Services External Link Disclaimer chart which includes information about "Diabetes Screening," "Diabetes Self-Management Training," and "Annual Wellness Visit." Read more.

The AMA also has a coding tipsheet for screening for prediabetes and diabetes. Click here to access the tipsheet.
encourage patients to enroll in the ymca's Diabetes Prevention Program

A Diabetes Prevention Program (DPP) is a structured way for participants to work on preventing diabetes. Generally, these programs are conducted in groups and help participants make changes in their lifestyle to reduce their risk for type 2 diabetes. The group leader or coach will work with participants on goals such as weight loss, healthy eating and increasing physical activity levels. The YMCA offers a CDC-approved Prediabetes Healthy Lifestyles program at six locations in Delaware. General information can be found on the national YMCA website.
 
Access the most recent listing of DPP classes available for your patients. Call 302.572.9622 or email diabetesprevention@ymcade.org for qualifications and further information.
Highmark Introduces DPP Benefit for Group Customers - Eligible Employees With The Benefit Can Enroll Beginning January 1

group Highmark Blue Cross Blue Shield announced that it will cover a new diabetes prevention program as a preventive benefit for group customers. The structured lifestyle and health behavior program, which is recognized by the Centers for Disease Control and endorsed by the Center for Medicare and Medicaid Services (CMS), can help prevent Type 2 diabetes in employees who are identified as pre-diabetic. 
 
The new diabetes prevention benefit will consist of a 12-month life style behavior change program.  Two program options are available- in person through a local YMCA (where available) or online/mobile through Retroft, a leading provider of weight-management and disease-prevention programs. Both programs include structured sessions led by a trained Lifestyle Coach that includes food, weight and activity tracking, as well as group support.  Click here  to view the full press release.
Emergency Medical Diabetes Fund Provides Assistance for Uninsured

The Delaware Emergency Medical Diabetes Fund provides diabetes services, medications, and supplies to residents of Delaware on an emergency need basis. It provides payment for items directly related to diabetes that will eliminate or alleviate the medical condition.

The program is administered by the Division of State Service Centers. For more information about the service, contact the Delaware Diabetes Prevention and Control Program .
ARE YOU MONITORING AND SUBMITTING YOUR PRACTICE'S NQF 0018 (HYPERTENSION IN CONTROL) & NQF 0059 (HBA1C NOT IN CONTROL) MEASURES?

HIT icon One of the top reasons to monitor and submit your National Quality Forum (NQF) data is to assure you are providing optimal care to your patients. Additionally, monitoring your data on a frequent basis can assist your practice in identification of opportunities for improvement. Other reasons include:
  • External importance for public reporting and payment reform
  • Consistency with/comparable to existing national measure sets
  • Allows for consistent comparison of primary care provider organizations or within Accountable Care Organizations (ACOs)
  • A tool to support clinical quality improvement initiatives
  • A tool to support additional financial benefits.
  • Implement processes already established and tested by others
CDC podcast discusses the impact of prediabetes 

" What is Prediabetes? " is a podcast from the CDC that takes a look at the implications of prediabetes and evidence that diabetes can be prevented or delayed.  Click here to listen to the podcast.
watch this video to learn more about the advantages of glucose testing 

play Screening adults for prediabetes has associated cost saving by preventing the progression toward diabetes. Many of the screening tests are fasting and inconvenient to the patients. Glucose tolerance testing could be a solution to current testing barriers. To learn more, please click here to access to the recording.

Note: Quality Insights can assist by sending a link to the Diabetes Risk Assessment to your patients through your patient portal at no cost. Please contact Ashley Biscardi today to request assistance. Additionally Quality Insights can supply your practice with paper copies and laminated versions of the Diabetes Risk Assessment in Spanish and English, or click here to download .
contact information

For more details about the Improving Hyperte nsion and Diabetes Care & Prevention project, please contact   Ashley Biscardi Sarah Toborowski, or Ryan Williamson.

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This publication was supported by the Cooperative Agreement Number 1U58DP004799-01 from the Centers for Disease Control and 
Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the 
Centers for Disease Control and Prevention. Publication number DEDPH-HD-121317