Public health challenges are tough, but collaboration makes a difference: Melissa Li-Ng and Kimberly Chen
CLEVELAND – As a practicing endocrinologist who helps lead the Cleveland Clinic’s COVID-19 vaccination effort and as Molina Healthcare’s chief medical officer, we share a good perspective for observing two of the crises most urgent health care facilities in the United States.
Getting more people vaccinated is essential for any hope of ending the pandemic’s grip on us. And helping more people with diabetes control their symptoms is key to improving their quality of life and lowering healthcare costs for everyone.
Ohio’s Medicaid managed care plans have given these two issues a high priority, and these efforts have taught an important lesson: Tackling persistent and difficult-to-manage public health issues is a team sport. By working together, the six private insurance companies that run most of Ohio’s Medicaid business are more successful than they could by working alone.
On the COVID-19 front, the plans agreed on a wide range of outreach efforts to encourage more Medicaid members to get vaccinated. The most important feature is a $ 100 gift card offered to any member who receives the first vaccine before December 31st.
At the Cleveland Clinic, we add to this with our own initiatives – encouraging patients, face-to-face or virtually, to get vaccinated; spread the message in print and online; welcome town halls; and providing on-site vaccination clinics for some large employers.
On diabetes, the plans agreed on a common strategy: to teach members how to manage their disease and to make it easier to get needed supplies. At the root of it all is a decision by the Ohio Department of Medicaid to cover expenses for Diabetes Self-Management Education (DSME) – instructions and advice on healthy eating and weight management. as well as the use of a glucometer, insulin pen and other tools.
There are also gift card programs for certain diabetic patients and caregivers, which focus on the dual purpose of more blood sugar tests by patients and better results for those tests. A patient with Medicaid diabetes who does not have such a test (called A1c) will receive a $ 25 gift card for having been tested by December 31.
Diabetic patients whose previous A1c test had a reading above 9% will receive a $ 50 gift card if they have another test before December 31 and their reading improves to less than 9%.
The two conditions are undoubtedly linked. We know that diabetic patients who contract COVID-19 are more likely to be hospitalized and their recovery is much more difficult. The infection can cause drastic fluctuations in blood sugar levels.
Immunize more Medicaid members and allowing more control of their diabetes will bring a significant improvement in the quality of life of these patients.
It is too early to measure the results of the diabetes campaign, but we are encouraged by the vaccination campaign. Governor Mike DeWine urged Medicaid plans in June to step up their efforts. The Medicaid department later said that between that date and August 8, the number of adult Medicaid members who had completed immunizations increased by 57%.
There is still a long way to go; As of Sept. 21, according to the Department of Medicaid, only 29% of Ohioans in Medicaid Managed Care plans were fully immunized. But that number is significantly higher than the 24% of Medicaid Ohioans overall – a clear sign that Managed Care plan efforts have been working.
Given the difficulty all communities have in encouraging COVID vaccinations, this success is real. Ohio faces many public health challenges, including obesity, heart disease and smoking, which COVID is making worse.
To move the needle on these and others, collaboration between health care plans, providers and the state is clearly a model to follow.
Dr Melissa Li-Ng is an endocrinologist and medical director of international operations and medical operations at the Cleveland Clinic. Dr. Kimberly Chen is Chief Medical Officer of Molina Healthcare of Ohio.
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