CLEVELAND -- As a practicing endocrinologist who happens to be helping lead Cleveland Clinic’s COVID-19 vaccination effort and as chief medical officer for Molina Healthcare, we share a good vantage point from which to observe two of America’s most urgent health crises.
Getting more people vaccinated is critical to any hope of ending the pandemic’s hold over us. And helping more people with diabetes keep their symptoms under control is essential to improving their quality of life and lowering health care costs for everyone.
Ohio’s Medicaid Managed Care plans have put a high priority on both of these issues and those efforts have taught an important lesson: Tackling persistent, hard-to-budge public health problems is a team sport. By working together, the six private insurance companies that handle most of Ohio’s Medicaid business are having more success than they could working alone.
On the COVID-19 front, the plans have agreed on a broad suite of outreach efforts to encourage more Medicaid members to get the vaccination. The most prominent feature is a $100 gift card available to any member who receives the first vaccination shot by Dec. 31.
At the Cleveland Clinic, we’re adding to this with our own initiatives — encouraging patients, face-to-face or virtually, to get vaccinated; spreading the message in printed materials and online; hosting town halls; and providing on-site vaccination clinics for some large employers.
Regarding diabetes, the plans have agreed on a common strategy: Teaching members how to manage their disease and making it easier to get the supplies to do so. Underlying all this is a decision by the Ohio Department of Medicaid to cover the expense of Diabetes Self-Management Education (DSME) — instruction and counseling on healthy eating and weight management as well as using a glucose meter, insulin pen and other tools.
There are gift card programs for selected diabetes patients and providers, too, centered on the twin goals of more blood sugar testing by patients and better results for those tests. A Medicaid patient with diabetes who has no such test (called the A1c) on record will receive a $25 gift card for getting a test by Dec. 31.
Diabetic patients whose previous A1c test had a reading higher than 9% will receive a $50 gift card if they have another test before Dec. 31 and their reading improves to below 9.
The two conditions are undoubtedly linked. We know that diabetic patients who contract COVID-19 are more likely to be hospitalized and their recovery is much more difficult. The infection can cause drastic fluctuations in blood sugar.
Getting more Medicaid members vaccinated and enabling more to control their diabetes will bring a meaningful improvement in the quality of life for these patients.
It’s too early to measure results of the diabetes push, but we’re encouraged by the vaccination campaign. Gov. Mike DeWine urged the Medicaid plans in June to ramp up their efforts. The Department of Medicaid later said that between then and Aug. 8, the number of adult Medicaid members who had completed vaccination grew by 57%.
There’s still a long way to go; as of Sept. 21, according to the Department of Medicaid, only 29% of Ohioans in the Medicaid Managed Care plans were fully vaccinated. But that number is significantly higher than the 24% of Medicaid Ohioans overall — a clear sign that the Managed Care plans’ efforts have worked.
Given the difficulty all communities are having with encouraging COVID vaccinations, this success is real. Ohio faces plenty of public health challenges, including obesity, heart disease and smoking, that COVID makes worse.
To move the needle on those and others, collaboration among health care plans, providers and the state clearly is a model worth following.
Dr. Melissa Li-Ng is an endocrinologist and medical director for international operations and medical operations at the Cleveland Clinic. Dr. Kimberly Chen is chief medical officer for Molina Healthcare of Ohio.
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