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Talking with Payers, Providers and Patients About Diabetes:
An AAPPO Toolkit for PPOs
Tab 3: Why Diabetes is Important to Payers
PPO leaders can use data on diabetes prevalence and incidence and in particular, information about the cost of diabetes in the working age population, to make the case to payers that diabetes quality of care is an important issue. The data referenced in this section will to help PPO leaders make the case to employers, health plans, and insurers that diabetes has both direct and indirect costs. It is a wise investment to adopt programs and strategies to prevent diabetes and improve the quality of diabetes care.
This section includes resources for payers:
National Diabetes Fact Sheet –United States 2005 http://apps.nccd.cdc.gov/DDTSTRS/template/ndfs_2005.pdf
Points to Make with Payers (Employers, Insurers, Plans):
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Diabetes is very common in working age people. According to the Centers for Disease Control and Prevention (CDC), 4 percent of people ages 20-39 have diabetes, and almost 10 percent of people aged 40-59 have diabetes. No employer of any size will be immune from the impact of diabetes on covered workers.
- The American Diabetes Association (ADA) says the total estimated cost of diabetes in 2007 is $174 billion, including $116 billion in excess medical expenditures and $58 billion in reduced national productivity.
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The
ADA found that medical costs attributed to diabetes include $27 billion for care to directly treat diabetes, $58 billion to treat the portion of diabetes-related chronic complications that are attributed to diabetes, and $31 billon in excess general medical costs.
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The largest components of medical expenditures attributed to diabetes are hospital inpatient care (50 percent of total cost), diabetes medication and supplies (12 percent), retail prescriptions to treat complications of diabetes (11 percent), and physician office visits (9 percent). This shows that keeping people out of the hospital should be an important goal!
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