According to a new report from CCS, American primary care physicians (PCPs) and endocrinologists feel that 85% of endocrinologists and 58% of PCPs are overwhelmed by the rise in patients.
In collaboration with independent market research firm Purespectrum, a study of over 100 PCPs and 100 endocrinologists highlights the key gap between patient education and coaching, which is essential for proper diabetes management.
Diabetes is one of the biggest challenges for the country's healthcare system, according to the report.
Over 11% of American adults live with a diabetic diagnosis, and 38% are classified as prediabetic. The estimated cost of diagnosed diabetes is $400 billion a year. Government data predicts a shortage of over 87,000 PCPs by 2037.
The importance of continuing education is known in patients, but fewer than half of diabetics receive formal guidance on managing their condition.
This study shows that health planning and pharmacy benefits managers (PBMs) are putting pressure on clinicians to move patients away from durable medical device (DME) companies.
While 91% of PCPs report providing diabetes-specific coaching and education, only 65% believe their patients have adequate access. Furthermore, 86% of endocrinologists and PCPs agree that a lack of continuing education is a major factor in low patient adherence to treatment.
Proper education and coaching are key elements of diabetes management, according to Dr. Arti Masturzo, CCS' Chief Medical Officer.
“The data is clear. Proper education and coaching is not an optional extra. It is the basis of successful diabetes management,” Mastruzo said. “As we face the expected surge among the 39.7 million Americans diagnosed with diabetes by 2030, we must urgently address these systemic gaps in patient support and education.”
One way to close these gaps is through policy changes and incentives that encourage health planning and PBMs to prioritize education-focused care over cost-driven decision-making, Masturzo suggests.
Some potential solutions include outcome-based contracts between PBMs, including health plans and patient education metrics, CMS-led incentives that reward improvements such as policy changes that require PBMs to assign a percentage of rebates to patient education initiatives, patient education metrics, and CMS-led incentives.
Furthermore, comprehensive patient education programs specific to technologies such as continuous glucose monitoring (CGM) and financial incentive mandates for health plans to implement comprehensive drug education programs may enhance patient support.
To measure the effectiveness of educational programs, Masturzo explained that CCS will evaluate key performance indicators such as CGM adherence, time within range, predicted A1C, reduced care gaps such as preventive screening, health, behavioral health, DSME measures (ADCES7), patient and patient provider satisfaction data, reduced care gaps, and reduced care gaps.
CCS also focuses on the impact that its programme has on referral physician overload, which serves as an extension of care teams to derail chronic care management for patients, health providers and health plans.
The report also highlights the benefits of prescribing CGM therapy through a DME provider rather than a pharmacy.
For example, 73% of endocrinologists and 69% of PCPs prefer to prescribe CGM through DME providers, as they provide excellent health coaching and education.
However, 45% of PCPs and 76% of endocrinologists feel pressured to their health plans to prescribe them through pharmacies instead.
This is true, but 92% of PCPs and 91% of endocrinologists are more likely to prescribe CGM through a DME provider if they want to ensure improved patient education and coaching.
To reduce the management burden of providers and allow them to concentrate more on patient education, CCS has built clinical solutions to help them train their CGM and train their training care teams to provide the same support directly.
Prophets, the organization's predictive analytics platform, can help people maintain prescribed treatments, but a holistic approach with coaching on lifestyle changes such as nutrition and exercise ensures that all the necessary resources will flourish for diabetics.
The study supports the idea that patients using CGM have higher adherence to treatment and lower overall healthcare costs when they receive supplies through a DME provider.
Healthcare providers play an important role in fostering patient care, trust and long-term relationships with patients.
Stephen Edelman, a professor of medicine at the University of California, San Diego, argued that clinicians should have the authority to make decisions that prioritize patient outcomes, rather than being exposed to external pressure from health plans.
Ensuring patients have access to the education, resources and support they need to manage their health is important for improving diabetes care in the United States