June 21, 2022
Health Leaders
By John Commins
Stakeholders want to increase access and support efforts to address social determinants of health.
KEY TAKEAWAYS
The push is part of a new initiative by ACAP and its 74 member nonprofit plans across the nation that provides a framework for stakeholders and policymakers to reduce health disparities and improve health outcomes.
ACAP wants federal policymakers to fund more benefits that address SDOH, including food, transportation, and housing programs, and to promote healthcare access by establishing continuous eligibility for people covered by Medicaid and CHIP and extending postpartum Medicaid coverage to 12 months.
ACAP is also pushing a learning collaborative to help Safety Net Health Plans advance equity across their members. The two-year program partners with the Center for Health Care Strategies to address health disparities and help nonprofit health plans develop and vet health equity strategic plans.
The Association for Community Affiliated Plans is calling on the federal government to strengthen support for efforts to address social determinants of health for the nation’s poor and underserved.
The push is part of a new initiative by ACAP and its 74 member nonprofit plans across the nation that provides a framework for stakeholders and policymakers to reduce health disparities and improve health outcomes.
Pathway to Improve Health Equity uses a three-pronged approach to increase equity among plan beneficiaries, who have low incomes, are disproportionately from communities of color, and may live with disabilities.
ACAP CEO Margaret A. Murray says the initiative will rely on robust data collection to support improvement on equity measures, pursuing public policies that improve equity, and listening and learning from the experiences of other plans.
“Increasing health equity requires a shared commitment from policymakers and health plans,” Murray says in a media release.
“With an intentional focus on measuring and reporting data, and more support for policies that improve health care coverage, Safety Net Health Plans will continue to lead the way in meaningful, innovative progress on health equity,” she says. “Policymakers can support these important efforts by backing policies that allow plans to address social determinants of health as an essential element of healthcare.”
ACAP wants federal policymakers to fund more benefits that address SDOH, including food, transportation, and housing programs, and to promote healthcare access by establishing continuous eligibility for people covered by Medicaid and the Children’s Health Insurance Program and extending postpartum Medicaid coverage to 12 months.
ACAP is also pushing a learning collaborative to help Safety Net Health Plans advance equity across their members. The two-year program partners with the Center for Health Care Strategies to address health disparities and help nonprofit health plans develop and vet health equity strategic plans.
“There are no silver bullets to solve the widespread, systemic disparities that plague America’s health care system, but there are concrete actions that can move the needle,” says Christopher D. Palmieri, president and CEO of Massachusetts-based Commonwealth Care Alliance and chair of ACAP’s board of directors. “Health equity can progress from an aspiration to a reality, but it requires policymakers to work with health plans and others in new and deliberate ways. The Pathway fuels that process.”
The rate of Americans diagnosed with diabetes isn’t slowing down, and the Covid-19 pandemic only exacerbated the risks and concerns for this debilitating chronic disease.
According to the American Diabetes Association, 1.5 million people will be diagnosed with diabetes this year. So why aren’t more people talking about it? The pandemic may have shifted the collective focus. After all, a nation in health crisis mode can only focus on so many problems at once. Yet hospitalizations and deaths due to diabetes or related complications were right behind the elderly and nursing home residents.
Aside from the pandemic pileup, the disease was not getting the attention it warranted, partly because of how the stigma attached to diabetes impacts our concern, even as it affects more people each year.
Between 1980 and 2014, the number of people with diabetes rose from 108 million to 422 million. “Prevalence has been rising more rapidly in low and middle income countries,” reports the World Health Organization. Diabetes can lead to blindness, kidney failure, heart attacks, stroke, and lower limb amputation.
Why Aren’t More People Talking About This?
“Diabetes is always swept under the rug because, in so many people’s minds, they just associate it with bad health habits and being overweight,” says Deena Fink of New York City. The Long Island native bartends in the West Village in addition to running a small online knitting business.
Most days, her Type 1 Diabetes doesn’t slow her down. It’s a disease she has been living with for sixteen years. “What really has to change is the stigma of diabetes,” Deena explains in an interview with Wealth of Geeks.
She is grateful for her health care plan, despite the roadblocks she often faces to receive her medication. “They have to start actually treating it as a chronic illness.”
Like many others during the first months of the pandemic, Deena was afraid to leave her house. “I didn’t even want to leave the house to go grocery shopping,” she says. The risks are different for someone with a chronic illness. “Just getting a cold, I am knocked out for several days.” She also could not get to a doctor’s office.
“You’re supposed to get your A1C done every quarter,” she explains, but she couldn’t see her doctor for a year and a half. So instead, Deena had to estimate what those numbers would be. The A1C test provides a three-month average of what blood sugar levels should be. It’s how a person with diabetes keeps themselves in range.
Deena faces a monthly battle with the insurance company just to receive her regular dosage of three insulin vials. Without insurance, she would have to pay $175 per vial.
The Global Factor
While lifestyle changes such as maintaining a healthy weight and diet, engaging in physical activity, and not smoking may decrease the health risks associated with diabetes, it does not guarantee that the disease won’t have harmful symptoms over time. Additionally, Covid-19 increases these risks across the globe.
Diabetes was responsible for 6.7 million deaths in 2021, according to the International Diabetes Federation. In addition to the 537 million adults living with diabetes today, an additional 541 million have Impaired Glucose Tolerance, a condition that places them at high risk of Type 2 Diabetes.
And what about the financial side? WHO reports that “diabetes caused at least 966 billion dollars in health expenditure – a 316% increase over the last fifteen years.”
As more people are diagnosed, the opportunity for visibility and change grows. Those with diabetes often become advocates for change.
“Stigma can result when you take an ‘invisible’ condition like diabetes out into the open,” says diabetes advocate Michael Donohoe of Ohio. When he was diagnosed with Type 2 Diabetes, he was also diagnosed with a heart condition. “I try to improve awareness and understanding by being as open about my diabetes as possible. I also advocate loudly for people who are newly diagnosed or severely impacted,” he says.
Covid Collision
Although the elderly and nursing home residents were hit hardest by the virus, people with diabetes were right behind them. This news comes to light as the total number of deaths in the United States nears one million.
“People with poorly controlled diabetes are especially vulnerable to severe illness from Covid, partly because diabetes impairs the immune system but also because those with the disease often struggle with high blood pressure, obesity, and other underlying medical conditions,” reports the New York Times.
Those with diabetes have to keep up with their disease constantly. “It’s a disease that’s a pain,” says Deena, “because you never stop taking care of yourself. Every decision you make for every day of your life will affect your diabetes.”
“It’s so much work,” she says, “but it keeps you alive.”
With diabetes diagnoses soaring across the globe, it is only a matter of time before the world stops hiding from this health crisis and confronts it head-on.
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