CareFirst BlueCross BlueShield credits a critical partnership with achieving top-tier results for Type 2 diabetes care.
CareFirst partnered with Ryse Health, a chain of clinics in the Washington, D.C. and Baltimore areas, focused exclusively on managing diabetes. CareFirst members who received care at Ryse Health clinics had, on average, scores in the 95th percentile for several HEDIS measures.
They were also much more likely to receive kidney evaluations and eye exams, as well as maintain statin adherence and blood pressure control. The effort also scored in the 90th percentile for patients with an A1C of 9 or more.
Zachary Rabovsky, director of population health strategy and practice transformation at CareFirst, told Becker's one of the challenges in manging diabetes is most patients diagnosed with diabetes do not receive support in the first year following their diagnoses.
Controlling diabetes requires lifestyle changes that are difficult without the right support and guidance, Mr. Rabovksy said.
"Having the support of a dedicated team of educators to work with you and figure out how this fits in your life moving forward — that's always going to be a barrier," he said.
It can be a three- to six-month wait to see an endocrinologist, Mr. Rabovsky said, and Ryse can help get patients into diabetes-specific care sooner. The referral stream can help primary care providers struggling to find care for their patients, he said.
"[It supports] primary care providers so they can focus on supporting their patient population, and not taking on the work of an endocrinologist," Mr. Rabovksy said. "They can feel confident that Ryse is going to communicate progress back to them."
Ryse Health's specific focus on diabetes care and lowering A1C levels is one factor behind the positive results. Other endocrinologists manage multiple hormone-related conditions, Mr. Rabovsky said.
Mr. Rabovsky said CareFirst plans to continue scaling the partnership until it reaches all of its members with diabetes.