HMOs Not Screening Enough For Diabetes Complications

Health Maintenance Organizations (HMOs) like to emphasize preventative medicine as a way to cut costs. Their screening rates for diabetic complications, however, suffer in comparison to screening rates by traditional fee-for-service organizations, according to a report published in the October 29, 1999 issue of Morbidity and Mortality Weekly.

Eye and foot exams, and glycosylated hemoglobin (GHb*) assessments, are beneficial in detecting early signs of complications associated with poorly controlled diabetes. These tests prevent people with diabetes from developing vision loss, kidney disease, amputation and disability. When researchers at the Centers for Disease Control and Prevention (CDC) evaluated 350 diabetic members of Rhode Island HMOs or Preferred Provider Organizations (PPOs) between 1995 and 1996, only 58 and 54 percent of members received annual foot and GHb examinations, respectively. The screening rates for retinopathy were more encouraging: 87 percent received annual dilated eye examinations.

The CDC says that efforts to improve testing rates should focus on educating patients, health care workers and HMOs on the value of each of these procedures.

*GHb: A blood test which measures the whole hemoglobin molecule rather than just a part of it, like the more common HbA1c. The units of measurement used in GHb tests are different from those used in computing HbA1c results.

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