The Catalyst Issue 21 | May 2015 - Page 16

COLLABORATION with caregivers and patients to create healthier lives Scott & White Health Plan receives top award from Texas Diabetes Council ABOVE THE REST In October 2014, the Texas Diabetes Council presented the Scott & White Health Plan with an award in recognition of its excellence in caring for diabetic patients. It is the only health plan in Texas to exceed state and nationwide standards set by the National Committee on Quality Assurance (NCQA) in six categories related to comprehensive diabetes care. receive NCQA accreditation, health plans across the nation must meet requirements established in a cluster of benchmarks called HEDIS (Healthcare Effectiveness Data and Information Set), a standardized set of clinical performance measures. Because diabetes is one of the most prevalent chronic and preventable diseases, the NCQA has established HEDIS quality care standards for optimal patient health. Diabetes affects more than 1.8 million people in Texas alone, according to the American Diabetes Association. People with Type 2 diabetes are unable to process the hormone insulin— necessary for metabolism—because of illness, obesity, metabolic syndrome (a cluster of symptoms, such as high blood pressure and blood sugar, unhealthy cholesterol levels and abdominal fat), or other factors. This situation creates insulin resistance and, if left untreated, can have a devastating effect on To patients’ eyes, kidneys, heart, and feet. The Texas Diabetes Council’s award underscores the value of the Scott & White Health Plan’s integration with Baylor Scott & White Health in achieving clinical quality standards that translate to better patient outcomes. “Having an insurance provider as part of the healthcare system is a critical piece. It’s an incentive to provide better preventive care to keep patients healthy and out of the hospital,” says Paul Godley, PharmD, director of pharmacy services at the Scott & White Health Plan. Diabetes Day makes a difference Part of the reason for the program’s success can be attributed to community outreach activities, including the annual Diabetes Day. This specially designated day provides an opportunity for patients to complete important care management activities, such as feet and eye exams. The health plan identifies patients with diabetes who haven’t been seen in a clinical setting for a while; health system clinicians provide necessary exams and laboratory tests, as well as education about healthy diet and exercise, and medication compliance, to help keep patients on track. Patient information goes into the electronic medical records (EMR) system, and alerts primary care providers of a patient’s status. Glen Couchman, MD, chief medical officer for the Central Texas division of Baylor Scott & White Health, credits the collaboration between the health plan and the healthcare system for helping patients with diabetes manage the disease. “We are proud of the teamwork that resulted in the Diabetes Council’s award,” he says. “Working together and remaining focused on quality are essential components to help all of our patients achieve their health goals.” n For more information on diabetes education and management programs at Scott & White Healthcare, visit 16 THE CATALYST May 15 |