Samantha A Barry1, Lena Teplitsky2, David V Wagner2, Amit Shah3, Brian T Rogers2, Michael A Harris4,5. 1. University of Massachusetts Medical Center, Diabetes Center of Excellence, UMass Medical School, 368 Plantation St., Worcester, MA, 01605, USA. 2. Oregon Health & Science University OHSU, 707 SW Gaines Street, Portland, OR, 97239, USA. 3. CareOregon, 315 SW 5th Ave, Portland, OR, 97204, USA. 4. Oregon Health & Science University OHSU, 707 SW Gaines Street, Portland, OR, 97239, USA. harrismi@ohsu.edu. 5. Harold Schnitzer Diabetes Health Center, Portland, OR, 97239, USA. harrismi@ohsu.edu.
Abstract
PURPOSE OF REVIEW: In this review, we outline barriers to appropriately caring for high-risk youth with diabetes and discuss efforts in partnering with insurers through Alternative Payment Models to achieve the Triple Aim (improved health, improved care, and reduced costs) for this population. RECENT FINDINGS: Current approaches in caring for youth with diabetes who evidence a high degree of social complexity are woefully ineffective. These youth are vulnerable to repeat diabetic ketoacidosis episodes, poor glycemic control, and excessive utilization of healthcare resources. To effectively pursue the Triple Aim, an "integrator" (i.e., an entity that accepts responsibility for all components of the Triple Aim for a specified population) must be identified; however, this does not fit into current fee-for-service models. Integrators for youth with diabetes are limited, but early examples of integrator efforts are promising. We present one successful "integrator," Novel Interventions in Children's Healthcare (NICH), and detail this program's efforts in partnering with insurers to serve high-risk youth with diabetes.
PURPOSE OF REVIEW: In this review, we outline barriers to appropriately caring for high-risk youth with diabetes and discuss efforts in partnering with insurers through Alternative Payment Models to achieve the Triple Aim (improved health, improved care, and reduced costs) for this population. RECENT FINDINGS: Current approaches in caring for youth with diabetes who evidence a high degree of social complexity are woefully ineffective. These youth are vulnerable to repeat diabetic ketoacidosis episodes, poor glycemic control, and excessive utilization of healthcare resources. To effectively pursue the Triple Aim, an "integrator" (i.e., an entity that accepts responsibility for all components of the Triple Aim for a specified population) must be identified; however, this does not fit into current fee-for-service models. Integrators for youth with diabetes are limited, but early examples of integrator efforts are promising. We present one successful "integrator," Novel Interventions in Children's Healthcare (NICH), and detail this program's efforts in partnering with insurers to serve high-risk youth with diabetes.
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