CHRONIC CARE

Chronic care management is recognized as a key factor in primary health care. It can help a patient maintain improved health and wellness by addressing ongoing symptoms as well as balancing medication regimens.

IEHP's quality measures help assess the management of chronic conditions, and our recent performance shows significant improvement in statin therapy treatment of patients with cardiovascular disease and diabetes. Statin therapy medications are prescribed by Providers to help decrease a patient's cholesterol. Our results also show an opportunity to improve in comprehensive diabetes care as well as treatment of patients with asthma medication.

Initiatives are already underway for improvement in these areas. For example, care coordination programs have been implemented to address chronic care management through a multidisciplinary team approach to include Physicians, Pharmacists, Utilization Management, Care Management, Behavioral Health and other health care Providers.

These programs identify IEHP Members with specific health conditions, harness insights from available health care data and evaluate individual outcomes — all with the goal of providing comprehensive, coordinated care for our Members.

The table below summarizes the percentage of Members who received recommended chronic care services.

Benchmarks based on NCQA Health Plan Rating Percentiles published 8/2022 unless otherwise noted.

= 90th percentile or above

= 66th – 89th percentile

= 33rd – 65th percentile

= 10th – 32nd percentile

According to the American Diabetes Association, diabetes is the leading cause of vision loss in people 18 to 64 years old. If symptoms are detected early and treatment is initiated in a timely manner, vision loss related to diabetes can be prevented.

So the vision is clear: IEHP partnering with Vision Providers can make a life-changing difference.

“We take great pride in the role we play on the team and strive to ensure every IEHP Member with diabetes is evaluated every year and every Member who may be at risk of vision loss is identified and receives needed treatment,” said Arthur Friedman, OD, an award-winning optometrist in the Inland Empire for more than 25 years.

With cooperation from participating Vision Providers, IEHP takes added steps to ensure Members receive a free diabetic eye exam.

In fact, as an incentive, IEHP even offers a $25 gift card to Members who complete their annual eye exam. Once these collaborations are established, the following steps are completed to help Members receive an annual diabetic eye exam:

• Participating Vision Providers receive a list of IEHP Members who are due for an annual diabetic eye exam and reside within the same city/ZIP code as the Vision Provider’s office location.

• Vision Providers contact Members from this list to schedule and conduct the eye exam.

• Members who complete the eye exam by the end of the year are eligible to receive a $25 gift card.

Results from these partnerships to prevent loss of eyesight include:

• In 2021, 35 Vision Providers chose to participate in this initiative, which included 5,000 Members needing eye care exams.

• In 2022, the program expanded to 100 Vision Providers participating with 9,000 Members impacted.

Fortunately, most diabetics are not at immediate risk of vision loss, according to Dr. Friedman, whose optometry offices in San Bernardino and Rancho Cucamonga, California, both specialize in family vision care, from toddlers to geriatrics.

“Even so, some diabetics are at risk,” he said. “The more Providers who participate, the more Member encounters, the greater number of at-risk individuals will be identified and the earlier we will identify those Members — early detection greatly increases the chances of a better outcome.”

As a bonus, the annual eye exams also offer an opportunity for a Provider to encourage patients to maintain medication schedules as well as diet and exercise programs, Dr. Friedman added.

“The upshot is the more encounters, the fewer people will lose vision and the lower risk of future vision loss,” he said

Overview

LIGHT THE WAY: When the 2022 Out of Darkness Community Walk faced cancellation due to no secured location, IEHP gladly stepped up as the event sponsor and host. On Oct. 29, 2022, more than 500 Inland Empire residents walked along IEHP’s Sixth Street campus in support of those affected by suicide.