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[IP] HMOs Agree On Treatment For Diabetics (T-2s in NY)

Source: Buffalo News - Financial Edition
Publication date: 2002-07-24

When you take your car to the oil change place, you expect that each time,
regardless of which shop you patronize, certain things will be done.

Certainly, the old oil and filter will be replaced with new oil and a new
filter. And usually, other fluids will be topped off, door hinges will be
oiled, and tire pressure will be checked.

That kind of standardization is pretty much what diabetes patients can
expect from their personal physicians from now on, regardless of which
Western New York health maintenance organization they use.

That will be possible because of new treatment guidelines unveiled Tuesday
by Community Blue, Independent Health and Univera Healthcare to ensure that
all diabetes patients receive the same, and the best, level of care.

"This is the gold standard of care," said Dr. John A. Gillespie, medical
director for Community Blue. "These guidelines are considered the best."

"Physicians find it difficult to provide different treatment to patients
based on their insurance coverage," said Dr. L. Ralph Pothel, medical
director for Univera Healthcare. "The joint guidelines will allow physicians
to focus their energy and resources on caring for members rather than
worrying about which guidelines apply to a patient."

The agreement on the guidelines, based on the American Diabetes Association
Standards of Care, was announced during a news conference in the American
Diabetes Association office in Amherst.

Until now, the health care providers said, each HMO had its own set of
guidelines for treatment of diabetic patients, and each physician had to be
aware of which set to apply to each patient based on his or her health

"Now the guidelines are all the same so they are easier to follow," said

The guidelines will be used to treat more than 100,000 people in Western New
York who have been diagnosed with Type 2 diabetes, the leading cause of
end-stage renal disease and blindness. Another 34,000 Western New Yorkers
are believed to have diabetes but are unaware of it.

Nationally, there are 16 million people with diabetes, according to Dr.
Paresh Dandona, head of the Western New York Endocrinology Center.

He termed the new guidelines "a common standard for treatment."

"To see the three companies come together means a great deal to people like
myself," said Steve Beauchamp, a WIVB-TV cameraman who is diabetic.

For patients like Beauchamp, the guidelines, summarized in an easy to follow
one-page chart, let them know specifically what tests to expect when they
visit their physicians and what part of the care is their own

The charts are being mailed to each physician in Western New York and are
available online on each of the health plans' Web sites.

They include a timeline for regular eye, foot and blood pressure
examinations, determination of the average blood sugar level over three
months, cholesterol testing, urinalysis screenings, immunizations,
self-management of nutrition and exercise, and counseling on tobacco use.

Dr. Michael Cropp, chief medical officer for Independent Health, said the
adoption of the guidelines is "part of a rising trend of such health plan
collaborations locally, throughout New York State and across the country."

Last year the three HMOs set standard guidelines for care and treatment of
asthma patients.

Research just released by RAND, a nonprofit research institution in Santa
Monica, Calif., found that well-educated and informed patients are better
able to follow complex medical treatment, as is typical with diabetes.

e-mail: email @ redacted

Publication date: 2002-07-24
) 2002, YellowBrix, Inc.

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