Multidisciplinary care teams needed to improve diabetes outcomes

The Affordable Care Act broadened access for individuals with diabetes in need of treatment; however, challenges remain in coordinating multidisciplinary care, securing federal research funding and approving treatments to address unmet needs, according to new recommendations issued by the Endocrine Society.

The society’s policy recommendations follow a September 2014 summit on diabetes and ACA implementation convened by the Endocrine Society in Washington, D.C.

“Although the full effect of the ACA’s impact on diabetes care is still being determined, several benefits and challenges are already clear,” Alvin C. Powers, MD, of Vanderbilt University Medical Center in Nashville, Tennessee, and colleagues wrote. “Improved access has lowered the barrier for individuals with diabetes to receive care.”

Improved access led to a 23% increase in Medicaid patients diagnosed with diabetes that adopted ACA Medicaid expansion vs. a 0.4% increase in states that did not, according to researchers.

However, expanded access exacerbates an existing problem: Demand exceeding the supply of available providers, both in primary care and among diabetes specialists, according to the report.

“A fundamental challenge in diabetes care is how we can transform multidisciplinary care teams to provide optimal care,” Powers said in a press release. “Coordinated care is necessary to ensure the best possible outcomes for people with diabetes. An effective team-based approach must provide comprehensive, continuous and timely care without duplicating any tests or services.”

The Endocrine Society’s 2014 workforce analysis found that the supply of endocrinologists who treat adults will outpace the growing demand for their services until at least 2024. The society recommends training more endocrinologists and primary care providers to adequately treat patients and support integrated care teams for people with diabetes.

The Endocrine Society made the following recommendations:

• Diabetes outcomes that are a direct result of ACA implementation should be monitored to understanding lasting impact on outcomes and value to diabetes care.

• Prevention and management of diabetes and prediabetes should be better integrated into health systems as well as community and employer-based health programs.

• Reimbursement for services should be linked to the achievement of appropriate, intermediate and longer-term outcomes, such as reductions in microvascular and macrovascular complications.

• The society recommends an expedited review and approval process by the FDA for treatments that address unmet needs in diabetes care, and an increase in federal funding to address knowledge gaps in diabetes care and promote the development of next-generation therapy options.

“Implementing these policies will improve care for people with diabetes and ensure Americans receive greater value for the hundreds of billions of dollars spent annually to treat and prevent the condition,” Powers said in a statement.

The recommendations were published online in The Journal of Clinical Endocrinology & Metabolism. – by Regina Schaffer

Disclosure: The researchers report no relevant financial disclosures.