Strategies for diabetes measures

Our quality improvement committee has reviewed the recommendations for the diagnosis and management of diabetes clinical practice guidelines and has adopted the standards of medical care in dabetes—2021, authored by the American Diabetes Association (ADA), which provides all of the ADA’s current clinical practice recommendations.

The ADA also has various resources in their patient education library.

Consider implementing a policy for standing orders for your patients with diabetes.

Type 2 diabetes videos and other educational tools are available to our members on their secure portal in the Healthwise® Knowledgebase.

The Centers for Disease Control and Prevention (CDC) offers a wealth of provider resources on their website to help you manage your patients with diabetes.

Strategies for controlling blood pressure measures

Our quality improvement committee has reviewed the recommendations for the evaluation and management of hypertension in adults and has adopted the 2017 guidelines for the prevention, detection, evaluation, and management of high blood pressure in adults.

If your patient is currently managed by a Capital Blue Cross care manager for another chronic disease, ask about our hypertension management program, which offers remote monitoring.

The American Heart Association Million Hearts® program offers tools such as blood pressure wallet cards and journals to share with your patients.

The CDC has hypertension resources for health professionals on their website such as tools, trainings, patient handouts, and communication materials.

Our secure member portal has multiple educational resources on high blood pressure including shared decision-making tools related to taking blood pressure for medication. This information is available in the Healthwise® Knowledgebase.

Strategies for both diabetes and blood pressure measures

Take advantage of our population health management programs and services, such as the care Management Program, to help support your patients. Direct any care management referrals to 888.545.4512.

Educate patients on understanding their diagnosis, managing medications, self-care, and communicating with healthcare professionals; remember to check with the patient for understanding. The best means of checking for patient understanding is the teach-back method.

Encourage patients to participate in auto-refill options for their medications, including 90-day prescriptions.

Engage patients in discussion of side effects, discomfort, etc., associated with medication and evaluate other options.

Properly document any reactions to medications.

Provide medication reconciliation with the patient/family member to verify current medications and any changes/additions, as well as the patient’s ability to afford the medications; if they cannot afford the medications, please contact your provider engagement consultant or submit a referral for care management by calling 888.545.4512.

Educate and encourage patients to self-monitor blood glucose and blood pressure, emphasizing the importance of bringing their glucometer and/or blood pressure monitor with them to every visit, or if participating in a telehealth visit, reporting those values to the provider upon assessment.

We works closely with our pharmacy benefit manager, Prime, using evidenced-based clinical rules to send out GuidedHealth® letters to our members. These letters include tips to help them better manage their medicines and education to help them start conversations about their medications with either their pharmacist or you, their provider. As their provider, you will also receive a letter that addresses medication adherence gaps in care, conflicting medications, as well as opioid red flags for your review. Use this notification as an opportunity to discuss those medications with your patients.