Helping High-Risk Diabetics and Pre-diabetics Through Preventive Care

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by Adam Paul

Diabetes is quickly becoming one of the more prolific chronic diseases in the United States. Statistics from the Centers for Disease Control and Prevention (CDC) indicate that diabetes has climbed up the cause of death rankings in recent years and is now the number seven most common cause of death. Diabetes affects more than 37 million Americans. This translates to about 11% of the U.S. population who need to deal with the health-related fallout of diabetes, costing them both health and life longevity as well as billions of dollars 

The importance of regular preventive care for diabetics, and even more so prediabetics, is becoming increasingly clear. Let's examine what this looks like within the domain of preventive healthcare services. 

Preventive Care for Diabetes 

Diabetes is a disease that often makes itself known during the medical history review and self-evaluation portion of the Medicare annual wellness visit (AWV). Roughly 1 in 10 Americans are diabetic. However, what's concerning is the fact that at least 1 in 4 of those 10 Americans are unaware they are diabetic. 

Preventive care for diabetic patients means frequent follow-up care to carefully manage blood sugar levels and other risk factors. Both chronic care management (CCM) and remote patient monitoring (RPM), optimally provided through a comprehensive care management program, can be valuable tools in supporting and caring for diabetic patients. Other preventive services, which can be ordered and coordinated during the annual wellness visit, include an annual eye exam to prevent or monitor diabetic retinopathy, an annual foot exam to prevent wounds from diabetic neuropathy, and regular lab tests to monitor the effectiveness of the current care plan.  

Preventive Care for Prediabetes 

Preventing at-risk patients from becoming diabetic should be the primary goal of diabetes-prevention-focused care. Since diabetes is known to "sneak" up on people, many patients don't know they are walking into its terrible clutches until it's too late. This makes preventing onset even more important and worthwhile. The CDC reports that about 96 million adult Americans are prediabetic, but more than 80% have no clue about their encroaching health issue. In primary care, and specifically for Medicare beneficiaries, the annual wellness visit is a great opportunity to discuss the patient's risk factors, both personal and familial, and plan for any screenings the patient might be due for, such as an A1c test and other pertinent labs.  

For patients who are at risk of developing diabetes, a preventive visit could be the single motivator needed to turn their health around. Prediabetes is also one of the most common chronic states that presents during the AWV. If a patient with prediabetes has been diagnosed with two or more other chronic conditions, they may also qualify to participate in a chronic care management program and/or remote patient monitoring, thus allowing them to work more closely with their healthcare team. This could be a game-changer for their overall health.  

Other prevention strategies to combat a prediabetes diagnosis from becoming a diabetes diagnosis include diet control and exercise. Preventive-focused care allows patients and practitioners to work more closely together, connecting the patient to resources that can help them reduce their overall chances of becoming diabetic.  

Preventive Services Lower Costs 

Payers have taken an active interest in the provision of preventive care — with such care increasingly delivered virtually — because healthier patients will translate to a healthier bottom line. The complications and comorbidities that accompany a diagnosis like diabetes cost far more to treat than providing an annual checkup, labs, and preventive patient education, especially if the chronic condition can be mitigated before it becomes a diagnosis.  

Under the Affordable Care Act, patients are covered to receive — and should be encouraged to participate in — regular preventive care visits at no out-of-pocket cost to them. Some payers cover some or all of other prevention strategies, such as exercise (e.g., gym memberships) and health coaching programs. These types of services cost significantly less than treating diabetes and the slew of complications that can accompany it.  

For payers, unprevented or uncontrolled diabetes can translate to costly fallout and invasive patient treatments such as surgeries for leg and foot amputations, treatments for vision loss, and expensive dialysis treatments for the kidney damage that can accompany severe diabetes disease. In addition, diabetes is frequently associated with expensive hospital admissions 

Prevention is a win-win for everyone. Keeping diabetic patients on track and in control of their diabetes management reduces payer and patient costs significantly and helps keep patients healthier for longer.  

Leveraging Technology to Strengthen Preventive Care 

Every day, we are learning more about what prevention strategies work, why they work, and how to best apply those prevention strategies to gain the most benefit. Some could even argue that the COVID-19 pandemic acted as a catalyst, further thrusting our healthcare system forward and forcing us to work towards identifying and using creative solutions to help prevent chronic disease progression while, at the same time, keeping potential virus exposures to a minimum. Through this process, coupled with the utilization of existing solutions like cell phones, internet, and secure online portals, care providers and technology companies are impacting prevention services in ways that improve their effectiveness and convenience.  

Tools that utilize technology, like chronic care management and remote patient monitoring, are bridging the gap between office visits, bringing care to the patient wherever they are, whenever they need it. For practitioners, this often means partnering with leading health technology companies, such as Prevounce. The result of such partnerships, and the newly derived revenue these programs create, are proving to be a win-win-win-win for patients, providers, payers, and the overall healthcare system.  

Promoting Wellness With Preventive Services 

The simple truth is that preventive care is one of the most effective tools we have in the fight against chronic diseases such as diabetes. By leveraging prevention-aimed services such as the annual wellness visit, we can help catch developing chronic diseases before they become a real problem or be in a position to respond with targeted services that can make a significant health and wellness impact. Altering the path a patient is on through simple lifestyle changes and support from their healthcare team can be cost-effective and easy to implement, thus better ensuring patient buy-in and engagement.  

For diabetic and prediabetic patients, preventive care can be the driver they need to remain healthier and help avoid common comorbidities that often develop after a diabetes diagnosis. Regardless of the chronic condition, preventive care is increasingly proving to be the catalyst that allows patients to live a longer, higher quality of life. 

Medicare Annual Wellness Visits Register

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