February 20, 2025
ACHP member Priority Health offers a diabetes self-management program to its employer group partners. For one employer, this partnership launched in 2016 to empower its staff to address diabetes. Priority Health assigned a registered nurse who is a Certified Diabetes Care and Education Specialist to serve as a dedicated care manager for the group and provide the members who enrolled in the program with an enhanced set of benefits.
The employees agree to meet with the care manager in-person, virtually or by phone quarterly and complete an annual dilated eye exam (with a waived co-pay). In return, they receive continuous glucose monitor (CGM) whether they take insulin or not, a reduced co-pay for diabetes-related medications, free lab tests related to diabetes care and a glucose meter with test strips.
The care manager works with patients to educate them on diabetes self-management, reviews CGM data, helps them set health goals and establishes touchpoints to assess progress. The CGM helps the members see cause-and-effect patterns in real time, while allowing the care manager to review data prior to the meeting and provide insights and feedback. The individuals can connect with the care manager more frequently than the quarterly appointments if needed, but if they miss two appointments, the patients may be disenrolled from the program. The care manager also collaborates with a clinical pharmacist on medication management and the provider’s office to address and close gaps in care.
The care manager acts like a coach, using motivational interviewing to help members with their own goals and empowering them to make the most of their primary care appointments. Since the care manager is certified in diabetes education and is embedded within the health plan, they can provide much-needed support. In one case, a care manager helped a mother whose child was newly diagnosed with type 1 diabetes navigate how to procure self-management supplies.
The tailored approach this program offers has resulted in high levels of engagement and success, with many members making lifestyle modifications and seeing improvements in their glycemic control. For example, a care manager collaborated with an individual recently diagnosed with diabetes and hypertension to set up monitoring for both conditions and help implement lifestyle changes that included smoking reduction, healthier eating and increased physical activity. The patient’s blood sugar levels went from 300 mg/dL to 100 mg/dL.
This program has been in place for eight years, with some individuals participating since the beginning and staying dedicated to the program. Overall, participants have lowered their A1c levels (a measure of blood sugar control) by about a range of 1.15% – 1.4% in the last year. Some individuals have seen even bigger improvements, for example, one person’s A1c went from over 14% down to 6.5%. Others saw their A1c drop at least 30% and in some cases, more than 50% since starting the program.
