2017 Florida Diabetes Report

2017 Florida Diabetes Report

Diabetes Advisory Council Department of Health

Department of Management Services Agency for Health Care Administration

Presented to Honorable Rick Scott, Governor Honorable Richard Corcoran, Speaker of the House of Representatives Honorable Joe Negron, President of the Senate

January 10, 2017

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Florida Diabetes Advisory Council/2017 Legislative Report

Florida Diabetes Advisory Council/2017 Legislative Report

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Contents

Contents........................................................................................................................................................ 3 Executive Summary....................................................................................................................................... 7

The Scope of Diabetes in Florida............................................................................................................... 7 The Public Health Consequences of Diabetes in Florida........................................................................... 7 The Financial Impact of Diabetes in Florida .............................................................................................. 8 Good News about Diabetes in Florida ...................................................................................................... 8 Introduction .................................................................................................................................................. 9 Problem Statement ................................................................................................................................... 9 Purpose of the Report............................................................................................................................. 10

Report Development........................................................................................................................... 10

Diabetes in Florida ...................................................................................................................................... 12 Statewide Prevalence of Prediabetes and Diabetes ............................................................................... 12 Prediabetes ......................................................................................................................................... 12

Adult Diabetes..................................................................................................................................... 14

Youth Diabetes.................................................................................................................................... 17

Diabetes and Pregnancy ..................................................................................................................... 17

Diabetes among the Medicaid Population ............................................................................................. 18 Medicaid Adult Diabetes..................................................................................................................... 18

Medicaid Youth Diabetes (0-17 years of age) ..................................................................................... 19

Medicaid Diabetes and Pregnancy...................................................................................................... 19

Diabetes among Individuals Covered by the Division of State Group Insurance ................................... 20 DSGI Adult Diabetes ............................................................................................................................ 21

DSGI Youth Diabetes (0-17 years of age) ............................................................................................ 21

DSGI Diabetes and Pregnancy............................................................................................................. 22

Public Health Consequences and Financial Impact of Diabetes ............................................................. 22 Health Status....................................................................................................................................... 23

Physical and Mental Health ................................................................................................................ 23

Comorbidities...................................................................................................................................... 24

Health Care Access.............................................................................................................................. 25

Emergency Department Visits and Hospitalizations............................................................................... 26 ED Visits over Time.............................................................................................................................. 26

Hospitalizations over Time.................................................................................................................. 27

Hospitalizations by Age Group ............................................................................................................ 27

Hospitalizations by Race/Ethnicity...................................................................................................... 28

Hospitalizations by Payer Type ........................................................................................................... 29

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Florida Diabetes Advisory Council/2017 Legislative Report

Hospitalizations by Length of Stay ...................................................................................................... 29 Lower Limb Amputation Hospitalizations........................................................................................... 30 Diabetes Mortality .............................................................................................................................. 31 Financial Consequences .......................................................................................................................... 31 Hospitalization Charges ...................................................................................................................... 32 Medicaid Costs .................................................................................................................................... 33 DSGI Costs ........................................................................................................................................... 35 State Agency Programs and Activities ........................................................................................................ 36 Department of Health ............................................................................................................................. 36 1305 ? Health Systems........................................................................................................................ 36 Health Equity....................................................................................................................................... 37 Diabetes Prevention............................................................................................................................ 37 Diabetes Self-Management Education ............................................................................................... 39 Diabetes Advisory Council................................................................................................................... 40 County Health Departments ............................................................................................................... 41 Department of Management Services - Division of State Group Insurance........................................... 42 Agency for Health Care Administration .................................................................................................. 43 Definitions ........................................................................................................................................... 43 Introduction and Objective ................................................................................................................. 44 Disease Management (DM) Program Overview ................................................................................. 44 Diabetes Disease Management (DDM) Program ................................................................................ 45 Co-Morbid Conditions......................................................................................................................... 48 Multidisciplinary Team Approach ....................................................................................................... 50 Diabetes Disease Management Program Effectiveness ..................................................................... 51 HEDIS Measures .................................................................................................................................. 52 Medicaid ? Diabetes Self-Management Training/Education (DSMT/E) ............................................. 52 Healthy Behaviors (HB) Program Overview ........................................................................................ 53 Smoking Cessation and Weight Loss................................................................................................... 54 Recommendations and Action Items to Address Diabetes ........................................................................ 56 Recommendation #1:.............................................................................................................................. 56 Action items: ....................................................................................................................................... 57 Recommendation #2:.............................................................................................................................. 58 Action items: ....................................................................................................................................... 60 Recommendation #3............................................................................................................................... 60 Action items: ....................................................................................................................................... 61

Florida Diabetes Advisory Council/2017 Legislative Report

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Action items: ....................................................................................................................................... 62

Recommendation #4:.............................................................................................................................. 63 Action Items: ....................................................................................................................................... 64

Recommendation #5:.............................................................................................................................. 64 Action Items: ....................................................................................................................................... 65

Recommendation #6............................................................................................................................... 66 Action Items: ....................................................................................................................................... 67

Recommendation #7............................................................................................................................... 67 Action items: ....................................................................................................................................... 67

Conclusions ................................................................................................................................................. 68 Appendix A. Data Sources and Methods .................................................................................................... 69

Data Sources ........................................................................................................................................... 69 Behavioral Risk Factor Surveillance System........................................................................................ 69

Pregnancy Risk Assessment Monitoring System ................................................................................ 69

Emergency Department Visits and Hospitalizations........................................................................... 70

Mortality Data ..................................................................................................................................... 70

Methods .................................................................................................................................................. 72 Race and Ethnicity............................................................................................................................... 72

Appendix B. Prediabetes Risk Quiz ............................................................................................................. 73 References .................................................................................................................................................. 74

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