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Diabetes is growing at an alarming rate in the United States.
The American Diabetes Association estimates more than 30 million Americans have been diagnosed with the disease, costing the nation over $300 billion in healthcare expenses every year.
This epidemic is especially true in West Virginia. The ADA reports that 15% of the adult population has been diagnosed with diabetes, and that an estimated 13,000 West Virginians are diagnosed each year.
This is why the Public Employees Insurance Agency (PEIA) is working with healthcare providers to bolster diabetes care statewide utilizing the Face-to-Face program.
PEIA launched the Face-to-Face Diabetes Management Program to change the approach to health management. Eligible patients enroll in the program, then choose a provider for routine counseling services concerning maintenance.
Mace’s Pharmacy in Philippi, WV, is one of the PEIA-approved educators who participate in Face-to-Face. Letetia Harper, Pharmacist-In-Charge, oversees the program at Mace’s Pharmacy, and she believes it has a positive impact on those who receive this additional education.
“Most of our patients deal with high cholesterol, high blood pressure, and diabetes. There are many cases of comorbidities. That’s a huge part of our population and the whole state,” she observes.
The lasting effects of Face-to-Face include:
Because enrollees are obligated to check in with their providers every three months, it encourages them to stay on top of their health.
“It definitely keeps patients accountable because they have to maintain a certain A1C level,” Letitia says. “If their A1C goes above 8, then they become un-enrolled, so that motivates our patients to monitor their health.”
Part of the success of Face-to-Face is its incentives. If members continuously meet the requirements of the program, then their copay for approved medications is waived completely.
The pharmacy even receives an MTM reimbursement for diabetic counseling and education through PEIA. And, everyone benefits from the decreased cost of healthcare spending by keeping patients with diabetes out of the hospital.
Letetia educates her participants on their medications, ensures they are adherent to their treatments and prescriptions, and helps them come up with an optimal diet and exercise plan that complements the rest of the care they are receiving.
“I’ve kept up with patients I’ve counseled over the years, especially the ones who have moved on to other insurance plans. They know that if they need something, even if they’re no longer in the program, they can talk to me,” she recounts. “It’s rewarding to see how people have improved over the years.”
The Face-to-Face initiative created many opportunities for West Virginia providers to have a positive effect on the statewide diabetes epidemic.
Pharmacists were especially effective, according to Letetia.
“I saw a few instances where the insurance policies would change which insulins they would cover,” she reflects. “One time, they switched from covering Lantus to Levemir, and for some reason, my patients’ A1C levels spiked.”
After researching other insulins covered by the insurance policy, Letetia found one similar to Lantus that worked for her participants. If not for the routine interactions required by Face-to-Face, this problem might not have been addressed so quickly.
Overall, West Virginia pharmacists like Letetia appreciate the results of the initiative.
“In our state, diabetes is on the forefront of our medical issues. I wish more pharmacies had diabetes education programs,” she conveys.
Although doctors’ offices do everything they can for their patients struggling with the disease, they often don’t have time for education or addressing questions.
Face-to-Face is “a huge commitment,” according to Letetia, but her years as a diabetic counselor have presented her with new ideas and possibilities.
PEIA requires providers to attend a 20-hour CE course to be eligible as an educator, but she is considering becoming a fully certified Diabetes Educator for Mace’s Pharmacy.
“This was a great foundation for us,” she says, “and we could definitely branch out and start our own program in the future.”
Pharmacists everywhere — not just West Virginia — have a unique opportunity to offer care and support in a way that will impact this widespread epidemic of diabetes.
