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angle-left Excellus BCBS members with diabetes are exceeding state, national rates for diabetic eye exams but pushing to meet higher goals

Excellus BCBS members with diabetes are exceeding state, national rates for diabetic eye exams but pushing to meet higher goals

For Immediate Release:  2018-03-27

Contact:  Karen Feigel (585) 238-4308

Rates of diabetic eye exams for Excellus BlueCross BlueShield members are higher than statewide and national averages. However, according to a new analysis of medical claims by the health insurer the rates are below target goals set for Commercial, Medicare and Medicaid populations.

“People with diabetes live with an increased risk of becoming blind, a condition that can be prevented most of the time by getting a complete eye exam each year. Early detection allows for early treatment,” said LouAnne Giangreco, MD, chief medical officer, health care improvement for Excellus BlueCross BlueShield.  “It can be challenging to make time in our busy schedules to prioritize our health. We are working with partners in the health care community to provide diabetic patients with those important reminders to have regular eye exams.”

Excellus BlueCross BlueShield collaborates with a variety of health care partners in the Rochester area to reinforce the importance of regular diabetic screenings. For example, in addition to regularly working with network providers to help identify gaps in care for diabetic members, Excellus BCBS helps support a diabetic care coordination program with Lifespan for older adults with diabetes. The program’s goal is to increase patient compliance to help reduce emergency room visits and hospitalizations.

Excellus BCBS reports data based upon a random sample of medical record reviews of members with diabetes. Comparisons of compliance rates of the members of other insurers are also reported. The chart below shows those comparisons by lines of business.

Footnote: The target goals are set by the respective regulatory body for each line of business.

Medicaid = NYSDOH, Commercial = NCQA, Medicare = CMS.

 

Diabetes is a serious health condition where the body does not produce or properly use insulin to digest sugar (glucose). Over time, high blood sugar levels can damage many parts of the body, including blood vessels and nerves in the eye. This damage can lead to diabetic eye disease and can result in blindness.

“If our numbers were a representative sample of the population of upstate, it would mean that approximately 180,000 out of 540,000 people with diabetes are not getting the eye exam that could save them from a major life-altering condition,” said Giangreco.

Excellus BCBS is working with local providers in the community to remove barriers to screening for diabetic patients. A recent Excellus BCBS grant provides retinal cameras to select UR Medicine primary care practices to improve screening rates. Installation and training for primary care personnel will be provided by the David & Ilene Flaum Eye Institute.  The goal of the program is to screen diabetic patients in the primary care setting at their normal appointments, removing the need to see a specialist or make another appointment unless an abnormality is found. At the time of the diabetic visit, retinal images are taken and transmitted to Flaum Eye Institute to be read under the direction of Rajeev Ramchandran, M.D., M.B.A., Associate Professor of Ophthalmology at the University of Rochester. The official reading will be returned to the primary care physician with specific recommendations. By having the screening in the same location and on the same day as the patients’ regular appointment, the screening is more convenient and more likely to be completed.

 “Patients with diabetic retinopathy have a 95% chance of keeping their vision if they receive treatment before the retina is severely damaged,” said Giangreco. “This retinal screening program provides services in the office making it more convenient for them to receive this important exam.”

Learn more about living with diabetes from the Excellus BCBS infographic, “Do you take charge of your diabetes?”Open a PDF .  Additional information is available from The Centers for Disease Control and Prevention at www.cdc.gov/diabetes/managing.

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Excellus BlueCross BlueShield, an independent licensee of the Blue Cross Blue Shield Association, is a nonprofit health plan with 1.5 million upstate New York members. The company's mission is to help people live healthier and more secure lives through access to high-quality, affordable health care. Its products and services include cost-saving prescription drug discounts, wellness tracking tools and access to telemedicine. With more than 3,500 employees, the company is committed to attracting and retaining a diverse workforce to foster innovation and better serve its members. It also encourages employees to engage in their communities by providing paid volunteer time off as one of many benefits. To learn more, visit ExcellusBCBS.com.