The National Clinical Care Commission Report to Congress: Leveraging Federal Policies and Programs to Improve Diabetes Treatment and Reduce Complications

Author:

Greenlee M. Carol1,Bolen Shari2,Chong William3,Dokun Ayotunde4,Gonzalvo Jasmine5,Hawkins Meredith6,Herman William H.7ORCID,Leake Ellen8,Linder Barbara9,Conlin Paul R.1011

Affiliation:

1. 1Western Slope Endocrinology, Grand Junction, CO

2. 2Population Health Research Institute and Center for Health Care Research and Policy, Case Western Reserve at The MetroHealth System, Cleveland, OH

3. 3Office of Generic Drugs, Center for Drug Evaluation and Research, Food and Drug Administration, Rockville, MD

4. 4Division of Endocrinology and Metabolism, Carver School of Medicine, University of Iowa, Iowa City, IA

5. 5Center for Health Equity and Innovation, Purdue University, Indianapolis, IN

6. 6Global Diabetes Institute, Albert Einstein College of Medicine, Bronx, NY

7. 7University of Michigan, Ann Arbor, MI

8. 8Juvenile Diabetes Research Foundation, Jackson, MS

9. 9National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD

10. 10Department of Veterans Affairs Boston Healthcare System, Boston, MA

11. 11Harvard Medical School, Boston, MA

Abstract

The Treatment and Complications subcommittee of the National Clinical Care Commission focused on factors likely to improve the delivery of high-quality care to all people with diabetes. The gap between available resources and the needs of people living with diabetes adversely impacts both treatment and outcomes. The Commission’s recommendations are designed to bridge this gap. At the patient level, the Commission recommends reducing barriers and streamlining administrative processes to improve access to diabetes self-management training, diabetes devices, virtual care, and insulin. At the practice level, we recommend enhancing programs that support team-based care and developing capacity to support technology-enabled mentoring interventions. At the health system level, we recommend that the Department of Health and Human Services routinely assess the needs of the health care workforce and ensure funding of training programs directed to meet those needs. At the health policy level, we recommend establishing a process to identify and ensure pre-deductible insurance coverage for high-value diabetes treatments and services and developing a quality measure that reduces risk of hypoglycemia and enhances patient safety. We also identified several areas that need additional research, such as studying the barriers to uptake of diabetes self-management education and support, exploring methods to implement team-based care, and evaluating the importance of digital connectivity as a social determinant of health. The Commission strongly encourages Congress, the Department of Health and Human Services, and other federal departments and agencies to take swift action to implement these recommendations to improve health outcomes and quality of life among people living with diabetes.

Funder

Agency for Healthcare Research and Quality

Centers for Disease Control and Prevention

Centers for Medicare and Medicaid Services

Food and Drug Administration

National Institutes of Health

Office of Minority Health

Health Resources and Services Administration

Indian Health Service

Publisher

American Diabetes Association

Subject

Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine

Reference53 articles.

1. Trends in receipt of American Diabetes Association guideline-recommended care among U.S. adults with diabetes: NHANES 2005-2018;Shin;Diabetes Care,2021

2. One-year outcomes of diabetes self-management training among Medicare beneficiaries newly diagnosed with diabetes;Strawbridge;Med Care,2017

3. Use of Medicare’s diabetes self-management training benefit;Strawbridge;Health Educ Behav,2015

4. It’s all about access!;Youssef;Diabetes Spectr,2020

5. Community Preventive Services Task Force . Interventions Engaging Community Health Workers. The Community Guide. Accessed 2 February 2022. Available from https://www.thecommunityguide.org/findings/diabetes-management-interventions-engaging-community-health-workers

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