Diabetes impacts about 35 million people in the United States. This equates to one in eight adults. The costs to individuals and employers are staggering. According to the most recent data published by the American Diabetes Association:
- Diabetes leads to 16 million emergency room visits and 8 million hospital stays a year.
- Individuals diagnosed with diabetes spend more than $9,500 annually to treat it.
- The disease costs employers $237 billion a year in medical care, and an additional $90 billion in lost productivity.
- Diabetes expenses continue to rise, with total economic costs increasing 26% over a recent five-year span.
Moreover, these numbers aren’t spread evenly among employee populations. Differences exist in access to preventive care, diagnoses and treatments for diabetes. These barriers are particularly pronounced for Native American, Black and Latino employees. And they result in worse health and financial outcomes, according to the Northeast Business Group on Health (NEBGH).
Based on these health disparities, the NEBGH recommends that employers incorporate diabetes management into their diversity, equity and inclusion (DEI) efforts.
Addressing disparities in diabetes care
Integrating diabetes management with your DEI initiatives can begin to address inequities. Follow these five steps to improve your processes:
- Understand employee challenges.
- Ensure access and affordability.
- Review mental health benefits.
- Provide targeted education.
- Examine the DEI efforts of vendors.
Understand employee challenges
To tackle inequities, you must understand the challenges facing your employees. Reviewing your claims experience can uncover gaps in health care access and reveal risks to diabetes management. Employee surveys can offer further insights into barriers to care.
Common challenges include mistrust of the health care system, poor understanding of your plan benefits and coverage, and lack of diversity among health care providers.
Once you understand your employees’ challenges, you can start identifying solutions. You might begin with smaller changes. For example, you can target your benefits communications to employees at higher risk of diabetes or those who haven’t been receiving preventive care.
Working with network providers to connect employees to diverse health care practitioners is another way to improve trust and adherence to medical treatment. You can also ask your company’s DEI leaders and employee champions to promote health benefits related to diabetes prevention and treatment.
Ensure access and affordability
When smaller changes don’t work, a health plan redesign may be in order. Your benefits adviser can help you assess whether health care access and affordability are hindering diabetes management.
Financial barriers are often the biggest impediment to diabetes care, the Society for Human Resource Management (SHRM) reports.
Use your DEI channels to promote the value of preventive care for diabetes management. Preventive care is typically free to employees and can stop issues such as prediabetes from becoming bigger health challenges. NEBGH recommends covering preventive care for diabetes, obesity and behavioral health.
To help employees afford medication and insulin, more companies are reducing or eliminating high deductibles and copays for diabetes-related care. Care for chronic conditions like diabetes can be considered preventive and provided to plan participants before they pay their deductibles — even in high-deductible health plans — according to IRS Notice 2019-45.
Digital tools are another way to improve health and combat high costs. A study cited by the International Foundation of Employee Benefit Plans showed that people with Type 2 diabetes saved $424 a month with continuous glucose monitoring.
But continuous glucose monitoring devices can be expensive and aren’t covered by all health plans. Designing your plan to cover these tools can help employees take advantage of them.
Review mental health benefits
Individuals with Type 2 diabetes often experience higher rates of anxiety and depression, reports SHRM. Unfortunately, mental health disparities exist along lines of race, ethnicity, gender and sexual orientation because of discrimination, inaccessibility and cultural stigma, according to the American Psychiatric Association. These disparities can be compounded by a lack of diversity among mental health providers.
SHRM recommends reviewing your mental health benefits to ensure resources are racially and culturally inclusive. Consider the following steps:
- Assess your mental health benefits and provider network for diversity, access and affordability.
- Educate your employees on the interconnectedness of mental and physical health. Explain how addressing underlying behavioral issues can save money and improve health outcomes.
- Normalize the usage of mental health benefits within your organization.
Provide targeted education
Targeted communications within DEI initiatives are a common practice. Enhance these efforts by personalizing education on employee benefits and diabetes care.
Your communications should be easy to understand and include actionable steps. For example, you may provide a series on understanding plan details like prior authorizations, claims denials and the appeals process. Or you could provide worksheets on diabetes medication management and lower-cost options for ordering medical supplies. In addition to diabetes management, cover related topics such as healthy food, fitness and obesity.
Wellness programs can promote physical and mental health benefits that reduce risk factors for diabetes. If participation is low among employees at higher risk for diabetes, target new efforts at increasing access and usage.
Use home mailings to involve dependents and affect positive changes at home. Depending on your employee population, you may want to offer communications in multiple languages.
Examine DEI efforts of vendors
Once you’ve made progress internally, turn your attention toward third parties by examining the DEI efforts of your health care vendors. Ask about their diversity practices to ensure they align with your company’s DEI goals and employees’ needs.
Work with your provider networks to increase diversity and equity among health care practitioners. Body types and norms can vary by culture, as can discussions around obesity and diabetes. Employees will be more likely to address diabetes and related health topics with providers who understand their life experiences.
For more ideas on integrating diabetes care into your DEI efforts, talk with your benefits adviser. They can help you review your claims experience for gaps in access and usage. In addition, they can provide insights into health plan design, mental health benefits and vendor management to enhance diabetes care for your employees.