Hello Colleagues,
Fall starts the unofficial eating season with Halloween treats and Thanksgiving feasts, followed by December holiday parties galore! For those with diabetes, these special occasions can be challenging. For those who do not know they have diabetes, these indulgences can take a heavy toll. The issue is so serious that November has a dedicated month (American Diabetes Month), week (National Diabetes Education Week: November 6 – 12), and day (World Diabetes Day: November 14) to call attention to it.
We understand the complexity of living with, and treating, diabetes. We usually recommend an interdisciplinary approach informed by current, evidence-based guidance. Medical societies update their guidelines frequently (see below for the current guidance) and we keep an eye out for their changes to stay informed.
We are here to assist you with the extra help you may need coordinating care and encouraging your patients to practice self-care. For example, when one member needed supplies to check their blood sugar, our Care Manager coordinated with their primary care provider and pharmacy to have $0 copay testing supplies sent directly to the member’s home. The Care Manager then made sure the member had full understanding of what they needed to do to keep their diabetes under control.
We have many resources to support you and your patients. We recently added care plans to our provider portal to give all treating providers easy access to them and to support coordination of care. See below for programs, classes, and materials we have available.
Chronic Obstructive Pulmonary Disease
Diabetes is only one of many complex conditions our members are dealing with. November is also COPD Awareness Month.
Chronic obstructive pulmonary disease (COPD) refers to a group of diseases that cause airflow blockage and breathing-related problems. We want to support you while you take care of our members. Services available for your patients with COPD include dedicated Care Management programs for patients who need disease education and coordination of care.
Vaccines
October is also the time of year for all of us to continue to drive home the message concerning the importance of vaccinations. Visit CDC.gov for vaccine considerations and what health care professionals should know about:
- MVP (formerly referred to as monkeypox)
- Polio
- Influenza
- COVID-19
We recommended vaccinations be considered according to age group. See the Prevention information available to our members.
Programs, Classes, and Resources
- We offer Care/Case Management programs for patients with complicated diabetes with comorbidities such as coronary artery disease (CAD) or chronic kidney disease (CKD), COPD, complex care, and more.
Members have access to nurse care managers, social workers, and pharmacists depending on their individual needs. Established care plans are shared on our provider portal—so set up an account if you haven’t already.
To refer a member to one of our Care/Case Management programs, you may contact us at:- EmblemHealth: See our Care Management Programs page for program descriptions, ways we can support you and your patients, and program-specific contact information. If you need general assistance, you can call 800-447-0768 Monday through Friday from 9 a.m. to 5 p.m.
- ConnectiCare: Call 800-390-3522 Monday, Thursday, and Friday from 8 a.m. to 4 p.m. or Tuesday and Wednesday from 8 a.m. to 7:30 p.m.
- EmblemHealth’s Pharmacy Programs can help with comprehensive medication reviews and we offer a Medicare-specific Medication Therapy Management Program to support adherence. We strive to integrate the latest pharmacological updates to prevent diabetes complications.
- Online virtual and in-person classes are available at our EmblemHealth Neighborhood Care and ConnectiCare Centers.
Current Medical Society and CDC Guidelines
- American Diabetes Association
- KDIGO guidelines focus on topics related to the prevention or management of individuals with kidney diseases.
- Centers for Disease Control and Prevention – COPD Guidelines, Reports, and References
Our Provider Resources
- Medicaid National Diabetes Prevention Program
- 2022 Quality Measure Resource Guide including diabetes quality measures
Our Member Resources
- GHI City of New York Members’ Diabetes Program
- EmblemHealth’s Diabetes Health and Chronic Obstructive Pulmonary Disease
- ConnectiCare’s Let’s Talk About Diabetes
What’s Next?
Next time, we’ll discuss our population health strategy and how we, as physicians in the plan and as practicing physicians in our network, play a role in shaping the future of our companies.
Sandra
Sandra Rivera-Luciano MD, MHSA, FAAP
Sr. Medical Director/Utilization Management
If there are other health topics you would like our perspectives on, please write to us at EmblemHealthMedicalDirectors@emblemhealth.com.
While we welcome your suggestions, we ask that you do not send protected health information (PHI) or patient-specific issues to this mailbox. This mailbox should not be used for Complaints, Grievances, Appeals, or Claims Inquiries. The Claim Inquiry and Message Center features in the Provider Portals (EmblemHealth|ConnectiCare) should be used for those issues.
