This is part three of prognostications. There are no predictions in this one. This is about another medical insurance company setting up a pilot program with the Medical Clinic of North Texas (MCNT). Aetna is saying this is a year-long initiative and will include adding a part-time bilingual diabetic educator. Claiming this pilot program strengthens Aetna's efforts to reduce disparities in health care, it also will develop and deliver culturally appropriate care for its members.
While this is a noble idea, what took them so long. While approximately 5000 persons will be involved in this pilot program, the program will use 17 distinct measures. They are generalized as improving levels of diabetic control, such as medication compliance, blood pressure, blood sugar and cholesterol rates, eye and foot screening rates, as well as other measures of quality health care, such as reducing avoidable inpatient and emergency room stays.
This sounds to me like a model for establishing criteria for claims denial in the future and not improved health care or even preventative health care. I can only hope that this is untrue and that these are not the motives.
The pilot program is located in Dallas, Texas. The patients and staff will be provided bilingual, and culturally correct educational information. The racial and ethnic data has been gathered and will be used to determine if the targeted interventions will improve the lives of the patients with diabetes.
Aetna says they will make an effort to see that all its members receive quality health care irregardless of the race or ethnicity. They also say they are committed to getting past the disparities in health care for minorities to lead to better health care for these populations.
Now I would challenge all medical insurance companies to be more open and actually do more all their members.
This is the final part in this series.
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