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Insurance companies have a constant challenge... helping their members manage disease to reduce complications and enhance quality of life. But they must also manage the cost of this care effectively.

The ediba® Diabetes Center of Excellence has developed a number of programs payors can use to more effectively manage diabetes among their members. These include:

  • Patient risk stratification - The ediba team can assist case managers in identifying high risk or non-compliant patients for assessment and follow-up.
  • Involvement in team meetings - Insurance industry and Medicare representatives participate in diabetes team meetings to learn about effective disease management tools.
  • Special programs - Special programs are available to partner with insurance companies to enhance care for their members. For example, Diabetes Stop is a multi-site screening program offered in conjunction with member hospitals and healthcare professionals.
  • Results monitoring - Information about improved quality and reduced costs is constantly monitored to document the efficacy of the program.
  • Partnerships - The ediba team with work in partnership with insurance companies to customize programs to meet specific needs.
  • Continuing education - Educational programs are available for case managers to learn the latest information on effective diabetes management.
  • Disease state management - The CHOICE Care program offers risk screening for diabetes and metabolic syndrome, along with clinical protocols for managing care, and monitoring compliance and outcomes throughout the course of treatment.
Improving Quality while Reducing Costs

Case Study

A major insurance provider sends all patients diagnosed with diabetes to an ediba® class for self-management training. Patients who can benefit from an insulin pump are given one at no charge, and sent to ediba for training by certified pump educators.

An analysis by the company showed this program saved $449 per member per year.