The public health challenges are tough, but working together makes a difference: Melissa Li-Ng and Kimberly Chen
CLEVELAND – As a practicing endocrinologist who happened to lead the Cleveland Clinic’s COVID-19 vaccination effort, and as Molina Healthcare’s chief medical officer, we share a good point of view for watching two of America’s most pressing health crises.
Vaccinating more people is vital to any hope of ending the pandemic’s impact on us. And helping more people with diabetes keep their symptoms under control is important to improving their quality of life and reducing healthcare costs for everyone.
Ohio’s Medicaid Managed Care plans have put both topics high priorities, and those efforts have taught an important lesson: tackling persistent, difficult-to-manage public health issues is a team sport. By working together, the six private insurance companies that run most of Medicaid’s Ohio business will have more success than they could work on their own.
On the COVID-19 frontline, plans have agreed on a wide range of efforts to encourage more Medicaid members to get vaccinated. The most outstanding feature is a $ 100 gift card for each member who receives their first vaccination by December 31st.
At Cleveland Clinic, we complement this with our own initiatives – we encourage patients to be vaccinated in person or virtually; Disseminating the message in print and online; Hosting of town halls; and providing on-site vaccination clinics for some large employers.
Regarding diabetes, the plans have agreed on a common strategy: teaching members how to manage their disease and making it easier to obtain the materials they need. All of this is based on a decision by the Ohio Department of Medicaid to pay for Diabetes Self-Management Education (DSME) – guidance and advice on healthy eating and weight management, as well as the use of a blood glucose meter, insulin pen, and other aids.
There are also gift card programs for select diabetes patients and providers that are geared towards the dual goal of getting more patient blood glucose tests and better results for those tests. A Medicaid patient with diabetes who does not have such a test (called A1c) will be given a $ 25 gift card to receive a test by December 31st.
Diabetics whose previous A1c test was greater than 9% will receive a $ 50 gift card if they take another test before December 31st and their score improves below 9.
The two conditions are undoubtedly related. We know that diabetics who become infected with COVID-19 are more likely to be hospitalized and their recovery is much more difficult. The infection can lead to drastic blood sugar fluctuations.
Getting more and more Medicaid members vaccinated and The ability to better control their diabetes will greatly improve the quality of life for these patients.
It’s too early to measure the results of the diabetes push, but the vaccination campaign is encouraging. Governor Mike DeWine called on the Medicaid plans in June to step up their efforts. The Department of Medicaid later said the number of adult Medicaid members who completed vaccination increased 57% between that time and August 8.
There is still a long way to go; As of September 21, only 29% of Ohioans on Medicaid Managed Care plans were fully vaccinated, according to the Department of Medicaid. But that number is significantly higher than the 24% total of Medicaid Ohioans – a clear sign that the efforts of the managed care plans have worked.
Given the difficulty all communities are facing in promoting COVID vaccinations, this success is real. Ohio faces numerous public health challenges, including obesity, heart disease, and smoking, which make COVID worse.
To move the needle with these and others, collaboration between health care plans, care providers, and the government is clearly a model worth pursuing.
Dr. Melissa Li-Ng is an endocrinologist and medical director for international surgery and medical operations at the Cleveland Clinic. Dr. Kimberly Chen is the chief medical officer of Molina Healthcare in Ohio.
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