Welcome to Technical Assistance
Welcome to the inaugural blog post of PA CCI. This blog will provide updates on the strategies that PA CCI is undertaking to help people prevent and manage chronic disease as well as stay current on exciting diabetes news occurring in Pennsylvania and around the country.
PA CCI was born out of the need to address the gaps in the management and prevention of diabetes throughout the commonwealth. This initiative attempts to tackle these issues through a multi-pronged approach; Technical assistance to increase the number of certified DSME/DPP programs, convening a Managed Care Organization work group, and promoting communication systems for enhancing Bi-directional referrals. These approaches seek to address issues in key areas of health care delivery including (1) the limited number of certified DSME sites and disparate distribution of programs, (2) reimbursement rate and insurance coverage, (3) referral policies and practices, and (4) barriers for people with diabetes (PWD) to DSME programs.
These are just four of many measures being funded by the Pennsylvania Department of Health Services through a grant from the Centers for Disease Control and Prevention to turn the tide against the increasing burden of chronic disease. PA CCI has its sights set on addressing all chronic diseases but first let us elaborate on our current approaches:
Technical Assistance to Increase Certified DSME Programs in Pennsylvania
Through an environmental scan of diabetes education in Pennsylvania it was found that many organizations provide or have the ability to provide DSME but for various reasons are not certified by the ADA or AADE. Some barriers to certification included application cost, lack of knowledge of how to apply, and not being able to sustain a program. The technical assistance branch of PA CCI was created to help organizations to overcome the perceived barriers of certification and increase the number of certified DSME programs.
Medicaid Managed Care Organization Workgroup
The MCO group brings together the managed care organizations to help solve the under-utilization of DSME, DPP, and other lifestyle disease interventions. The initial strategies identified are aimed at overcoming the obstacles and challenges providers face in referring patients for DSME. PA CCI, in coordination with the MCOs, is seeking to improve physician education and awareness of the availability, benefits, and referral procedures of DSME programs.
Communication Systems for Enhancing Bi-directional Referral
PA CCI in partnership with the Pennsylvania Department of Health, Quality Insights of Pennsylvania (QIP), Pennsylvania’s Quality Improvement Network (QIN) for the CDC, and other multi-sector partners are developing a replicable, sustainable model to increase and improve community-clinical linkages and bi-directional referrals. The key of Bi-directional referral systems is to close the loop between a patient’s provider and chronic disease management programs to improve patient care.