Recorded presentation

Millie Havens, RN¹, Nancy Wongvipat, MPH², David M. Bodick, MPH³, Steve J. Owh, MPH⁴, Bruce Chernof, MD, FACP⁵, and Geralyn Lara Soliz, BSN¹. (1) State Health Programs/Health Care Services, Health Net of California, Inc., 21281 Burbank Blvd., Woodland Hills, CA 91367, (818) 676-6811, geralyn.l.soliz@health.net, (2) State Health Programs, Health Education Department, Health Net of California, Inc., 1055 E. Colorado Blvd. Suite 300, Pasadena, CA 91106, (3) State Health Programs/Health Education Department, Health Net of California, Inc., 11971 Foundation Place, Rancho Cordova, CA 95670, (4) State Health Programs, Quality Improvement, Health Net of California, Inc., 21281 Burbank Blvd., Woodland Hills, CA 91367, (5) State Health Programs, Health Net of California, Inc., 21281 Burbank Blvd, Woodland Hills, CA 91367

Health Net arranges health care for more than 625,000 Medi-Cal members of whom 10,000 have diabetes that require medication or has resulted in inpatient or emergency room (ER) utilization. Diabetes is a disease with significant short-term impact as well as profound long-term implications for which meticulous screening, aggressive therapy and effective case coordination can prevent complications. The American Diabetes Association has published evidence-based guidelines for many years, yet the literature shows that actual rates of screening and treatment routinely fall short of these recommendations. Many reasons exist for this gap including physician awareness, member motivation and cultural and linguistic barriers. Based on these identified needs, Health Net developed Diabetes – Be in Charge!^sm, a diabetes disease management program tailored to the specific needs of Medi-Cal members, modeled from the Center for Health Care Strategies’ (CHCS) Best Clinical and Administrative Practices (BCAP) program. Diabetic members are stratified into risk categories with educational interventions designed for each risk category. An integrated system of intervention that includes member and provider education, internal and external collaboration and medical management is a core ingredient to achieving successful outcomes. This multi-level intervention initiative was implemented to test program effectiveness and the feasibility of implementing such a model in a Medicaid Managed Care setting. Processes of program development and evaluation measures such as knowledge and behavioral changes, hospital utilization and clinical outcomes, including hemoglobin A1C, retinal screening and proteinuria will be discussed. Effectiveness of intervention components by risk stratification will also be evaluated and discussed.

Learning Objectives:

• Describe the advantages and opportunities of utilizing specific intervention components in implementing a diabetes program in a managed care setting.
• Identify the key steps needed for effective diabetes program development.
• Assess the feasibility of a multi-level intervention approach to implementing a diabetes program in their settings.

Keywords: Diabetes, Disease Management

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation