Diabetes Disease Management Program

Our Approach

Although diabetes cannot be cured, it can be managed. Proper management leads to dramatic health improvements. At QMed, our comprehensive Diabetes Disease and Case Management Program is designed to significantly improve the treatment and compliance of adult diabetics by working in conjunction with the patient's physician. Our program provides evaluation and best-practice care based on national guidelines with all components, from education to personal support, based on each patient's health status.

• Accurate patient identification: Our powerful and proprietary predictive modeling tools accurately identify patients with diabetes and its co-morbidities.
• Rapid enrollment: We quickly enroll these patients into the program for primary and secondary prevention. Importantly, our comprehensive review proccess includes the use of patient-specific abstracted chart data, producing electronic medical records for improved healthcare delivery.
• Risk Stratification: Sophisticated analytics stratify members into low, moderate, and high-risk groups for targeted intervention, empowering physicians with recommendations linked to the plan formulary.
• Ongoing surveillance: A continuous record of each patient's evaluations and automatic reminders for future evaluations are just some of the examples of our continuum of care to improve overall health.
• Comprehensive reporting: Health plans receive customized reports of outcomes and quality improvements to see demonstrated, positive health and financial outcomes, on an ongoing basis

The QMed Advantage—Engaging Physicians. Empowering Patients.

Our comprehensive Diabetes Management Program is designed to significantly improve the treatment and compliance of adult diabetics. We are committed to delivering clinical care services built on our multi-faceted approach, designed with both the patient and physician in mind. Using our superior healthcare information systems, we provide physicians with patient-specific, evidence-based recommendations. Our data is gathered from the most comprehensive array of sources—including information from abstracted patient medical charts. We ensure physicians have the best information with which to make appropriate treatment decisions, to improve patient health, and reduce chronic episodes.

Patients with co-morbidities such as heart disease, heart failure and/or chronic obstructive pulmonary disease are also managed. By managing these diabetic co-morbidities, the patient will have a better quality of life and less Emergency Room visits and hospitalizations.

We also provide patients with the medical and personal support needed to help them better manage their disease and live a healthier, more active life. A skilled Care Manager is assigned to each patient to provide the guidance and support diabetics need to make these lifestyle changes, including compliance monitoring and blood sugar level tracking when necessary. Care Managers are the experienced, resourceful professionals who help patients set goals and ensure they are met. Patients may also receive our 6-week core educational course, which allows ample time to get to know their Care Manager on a personal basis. Patients are given regular updates and surveys to track their ongoing needs and progress.

Eligibility Requirements

Requirements for eligibility and program participation include individuals over the age of 18 with either Type I or Type II Diabetes.

Program Benefits

We support physicians by providing individualized recommendations for optimally managing diabetes patients based on National Guidelines.

• We conduct regular chart reviews on appropriate patients to gather all pertinent information and to assess severity and other co-morbidities.
• All data from this evaluation is entered into our robust database, which utilizes stratification analysis to automatically stratify patients and generate evidence-based recommendations within 24 hours.
• When trends indicate a change in a patient's health status, the treating physician is notified and the patient can be assessed before expensive emergency room or hospital care is required.
• We recommend based on national guidelines diabetic, lipid, hypertensive, and other medications.
• We provide physicians with patient progress updates.
• We design programs to ensure minimal impact on the physicians' daily workflow.

We support patients, empowering them with self-management tools, educational materials, and individualized support specific to each patient's needs. We also provide Health Risk Assessment to determine beneficial services for each patient case. Our Care Manager provides patient support between visits.

• We schedule periodic phone calls to gauge how patients are feeling, review progress, medications, and discuss any concerns.
• We educate patients on warning signs and symptoms.
• We inform patients about medications, tests, and exams important to their health.
• We provide educational materials including booklets, brochures, newsletters, and wallet cards.
• We instruct usage of a home medical device to monitor symptoms on a daily basis (where appropriate).
• We alert patients to reminders for tests, lab work, and vaccinations.
• We schedule talks with you to go over your progress, medicine and any concerns.
• We work with families and community resources.

Our Diabetes Disease and Case Management program outcomes are proven and measurable—all measures achieved show a greater improvement than the national benchmark, defined by the American Diabetes Association:

• 25% reduction in Blood Pressure
• 15% reduction in LDL Cholesterol
• 22% reduction in HbA1C
• 25% increased use of Aspirin
• 9% reduction in diabetic patients who smoke
• 9-10% approximation of financial savings