DC Plan Rolls Out Diabetes Texting Pilot

Washington, DC-based Medicaid managed care organization, D.C. Chartered Health Plan, is rolling out a pilot text messaging program for members with diabetes. The Medicaid plan is providing 50 of its members with the free messages, which will include tips about living with diabetes, as part of a broader program that includes in-person visits.

The texts aim to encourage patients to schedule annual appointments and get annual eye and foot exams in an effort to avoid unnecessary trips to the emergency room. The texts also include tips for taking medication “appropriately” and other tips for lifestyle changes that would benefit their health. The texts are not all one-way, however, some are interactive quizzes and others are announcements for community events.

In the future, Chartered hopes to expand the program if it proves successful. The plan expects to develop support groups for various diseases, send disease-specific messages, and personalized messages like appointment reminders.

“Mobile health is the wave of the future for improved management of chronic disease,” Dr Richard Katz, director of the division of cardiology at the George Washington University Hospital, stated in a press release. “It can be extremely popular with diabetes patients and result in reduced emergency room visits and hospitalizations.”

Last year George Washington University Hospital partnered with Chartered Health Plan on a pilot of WellDoc’s DiabetesManager. In December 2011 MobiHealthNews reported that Dr Katz had presented findings of a demonstration program called DC HealthConnect at the mHealth Summit in Washington DC. The program tested WellDoc’s mobile health program DiabetesManager during a 12-month period. The results: DiabetesManager reduced ER visits and hospital stays by 58 percent on average compared to the previous year — when they weren’t using the program.

“Our goal is to leverage mobile technologies and smart networks to improve the well-being of our community,” Chartered executive Karen Dale stated. “We’ve been committed to improving the quality of care, reducing costs and creating a healthier community for the past 25 years, and will continue to take advantage of new opportunities to solve Washington’s most critical health and social challenges.”

More in the press release below:

WASHINGTON, April 9, 2012 – D.C. Chartered Health Plan, Inc., the oldest Medicaid managed care organization in the District of Columbia, is launching a new text messaging program for 50 of its members to help them better manage diabetes, which requires regular care to avoid costly complications. This program enables participants to receive brief tips about living with diabetes, a disease that disproportionately affects the community, as part of a case management program that also includes face-to-face support.

Research shows that people who actively participate in their care can more effectively manage chronic diseases such as diabetes. In many cases, however, particularly in the neighborhoods Chartered serves, people with diabetes find it difficult to understand and manage the disease. The new program provides a different avenue for education.

“Mobile health is the wave of the future for improved management of chronic disease,” said Richard Katz, M.D., director of the division of cardiology at the George Washington University Hospital, which previously partnered with Chartered Health Plan on a similar program. “It can be extremely popular with diabetes patients and result in reduced emergency room visits and hospitalizations.”

Diabetes affects local residents at substantially higher rates than in other areas of the country. In 2010, 10.9 percent of adults in the District received a diabetes diagnosis, compared with only 8.7 percent nationwide, and death rates associated with the disease are also disproportionately higher. Poorly managed diabetes can lead to complications such as blindness and foot problems, often leading to costly emergency room visits that could be avoided.

“This program connects our diabetic members to the real-time support they need,” said Karen Dale, an executive at Chartered Health Plan. “Through this and other innovations, we’re opening doors to good health for those who need it most in our community.”

Bridging the gap through text messaging

For years, Chartered has sought to keep members with diabetes engaged in their care through regular telephone calls and mailings, as well as face-to-face interaction with members. By adding a text messaging element, Chartered is expanding the impact of this effort and enabling members to play a more active role in the management of their disease.

The program encourages members to avoid unnecessary emergency room visits and instead, to schedule annual appointments with their primary care providers as well as get annual eye and foot exams. It also helps people take their diabetes medicines appropriately and make lifestyle changes to better support their health.

Participants in the program receive tips and messages on various topics, including when to contact a doctor, nutrition tips and diabetes-related information. The text messages also include interactive quizzes and announce community events to keep participants involved.

Future plans

The program will be evaluated later this year with an eye toward potential expansion. It is part of Chartered’s commitment to transform health care in the District. Building on its secure cell phone technology platform, Chartered ultimately hopes to create support groups for various diseases and send other disease-specific messages and personalized messages, such as appointment reminders, to its members.

“Our goal is to leverage mobile technologies and smart networks to improve the well-being of our community,” said Dale. “We’ve been committed to improving the quality of care, reducing costs and creating a healthier community for the past 25 years, and will continue to take advantage of new opportunities to solve Washington’s most critical health and social challenges.”

About Chartered Health Plan

As the oldest Medicaid managed care organization in the nation’s capital, Chartered Health Plan, Inc. is the most comprehensive resource for local residents with serious health conditions. Chartered opens doors to good health for those who are most at risk, facilitating care to more than 100,000 people who are Medicaid-eligible or uninsured, who would otherwise have limited access to the care they need.

Chartered recognizes that good health also depends on addressing a number of social factors, such as employment and a stable and safe living environment. That’s why Chartered cares about the “whole person,” offering innovations that address these factors and empowering members to become actively engaged in their care. The National Committee for Quality Assurance (NCQA) awarded Chartered an accreditation status of commendable for service and clinical quality that meet NCQA’s rigorous requirements for consumer protection and quality improvement.

SOURCE Chartered Health Plan

Periodontal Care Linked to Diabetes Management

‘Striking’ Data Links Periodontal Care to Lower Diabetes Costs

John Commins, for HealthLeaders Media , March 27, 2012

An insurance industry study, touted as the largest of its kind, shows that medical costs can be reduced by more than $1,800 a year for each diabetic patient who receives periodontal care.

The study examined medical records from more than 1.6 million people who were covered by both United Concordia Dental and Highmark Inc. and identified about 90,000 Type 2 diabetics.  About 25% of those diabetics elected to receive periodontal treatment in 2007 and the study compared their medical costs over the next three years with the 75% of diabetics in the group who declined the oral care.   

“The data is striking. In 2007 you had fewer than half the inpatient admissions if the patients had periodontal surgery when compared with the patients who did not,” says Marjorie Jeffcoat, DMD, with the University of Pennsylvania, the lead author of the study.

“I also found it striking that this result was carried through for three years,” Jeffcoat told reporters at a Monday teleconference. “If you look at the mean number of visits they paid to a physician, again in 2007 they saw half the number of physician visits and this statistically significant result was carried through again for three years.”

“If we look at mean medical costs we have a reduction in all three years and if you look at it the mean medical savings was $1,814 per patient per year. That is a striking number. This affect is apparent two years after the periodontal treatment,” Jeffcoat says.

The study’s release coincided with United Concordia launch of a diabetes-specific program that provides 100% coverage for surgical procedures, other treatments, and maintenance for patients with gum disease.

“This is the most statistically conclusive study proving the relationship between oral health and medical cost savings. The savings are just the start of what is to come,” United Concordia COO/President F.G. “Chip” Merkel told reporters. “We believe that employers will realize reduced medical costs when their employees with diabetes receive appropriate periodontal care.”

James Bramson, DDS, chief dental officer for United Concordia, noted that about 25.8 million Americans have diabetes, a number that has doubled since 1999. He says the sheer size and scope of Jeffcoat’s study shows “that the results here are not a fluke.”

“We did some modeling to look at the ability to take care of these kinds of patients and the cost of doing that and what kinds of savings you’d have on the medical side,” Bramson says. “In a group of about 200 members, even as small as that, it would only take about 3% of the diabetics to actually return the savings on the medical side equal to what it would cost to provide these additional treatments. Beyond that all the rest is healthcare savings.”

While the study examined diabetics, Bramson says other studies have provided linkage between oral health and coronary artery disease, cerebral vascular disease, and even premature and low-weight infants. “We believe other chronic diseases will show some association, some economic savings medically if those people had periodontal treatment,” he says. “So when we know more about the breadth and depth of the accuracy of that savings across those other diseases our hope here is to broaden the coverage we are now starting with diabetes.”

“The thought is you don’t need to cover everybody in the population,” he says. “The better thing to do is cover those targeted populations where we can show savings and where we know an intervention program of information and assistance will help them get in and get the treatment they need.”

Bramson says dentistry accounts for about 4% healthcare spending in the United States, while hospital care, physician and clinical services, and drugs account for 63% of all spending. “If we can improve the spending in the dental that is going to affect the three other largest segments of the healthcare spending, so we believe you will have some savings well beyond the $1,814,” he says.

The study did not specifically examine the cause-and-effect relationship between periodontal disease and diabetes, but Jeffcoat says earlier studies have explained the linkage.

“Any sort of infection you have, be it pneumonia, a kidney infection, it makes your diabetes worse,” she says. “Periodontal disease is an infection. If we can get that infection under control we tend to get the hemoglobin A1C, the measure of three months of diabetes, under control. It has to do with inflammation and infection and getting it under control.”


John Commins is an editor with HealthLeaders Media. He can be reached at jcommins@healthleadersmedia.com.