The Alliance to Reduce Disparities in Diabetes, a national program launched and supported by The Merck Company Foundation, released "Policy Considerations That Make the Link," that offers policymakers options for ways to advance changes to overcome the systemic and structural barriers that have blocked the ability to deliver and sustain effective diabetes care to those most in need.
"The document connects the on-the-ground experiences of the Alliance grantees with the issues facing national decision makers as they consider ways to get more value, quality, efficiency and innovation into our health care system," Noreen Clark, PhD, Director of the Alliance's National Program Office said.
The considerations pose a series of questions surrounding the identified need to realign financial incentives affecting health systems, providers and patients as a mechanism for reducing disparities in diabetes.
"The release is particularly timely," Clark said, "given that newly elected and reelected leaders in Washington will be thinking about how to move forward with health reform implementation. The policy considerations document addresses directly the structural barriers Alliance grantees have encountered in the health care delivery and financing systems," she said.
The structural barriers include:
- The health care system's focus on payments based on units of care, on specialty care and high-cost, high-tech interventions;
- State credentialing standards that present barriers to payments for vital health workers;
- Technologies, costs and policies that can obstruct timely, comprehensive and robust exchange of patient information;
- A lack of designated, adequate and consistent payment for community health workers that can provide people with diabetes needed links to community resources and education; and
- Inadequate integration between health care systems and public health departments that limit care coordination and optimal use of resources in assisting diabetes patients.
- Encourage greater integration of public health and health care systems
- Share and report community-wide health data
- Eliminate incentives that encourage underinvestment in low-income, high-risk patients
- Optimize Accountable Care Organizations' (ACOs) abilities to reduce disparities
- Support deployment of Community Health Workers (CHWs)
- Concepts offered to address patient needs include ways to:
- Enhance diabetes self-management supports