By Carol Zicker, RN, Certified Diabetes Educator, Horizon BCBSNJ​

Diabetes has been called a modern epidemic, touching nearly every part of the globe. New Jersey is no exception.

About nine percent of adults in New Jersey have diabetes – and that figure doesn’t account for the thousands more who may not know that they have it. Diabetes is the eighth leading cause of death in the state, and the fifth leading cause among Black, Hispanic and Asian residents, translating to about 2,000 deaths every year in New Jersey due to diabetes. 

Unlike some epidemics, the onset of diabetes can be delayed or sometimes even prevented and the condition can be effectively managed through lifestyle modifications in conjunction with medications. Healthier eating, exercise and visits to the doctor can help prevent or control Type 2 diabetes, the most common kind of diabetes. Better management of diabetes, along with the management of high blood pressure and high cholesterol which often occur together, can delay or avoid complications, including kidney failure, amputations, blindness and cardiovascular disease.

Health insurers also have a role to play in reversing these trends. Horizon Blue Cross and Blue Shield of New Jersey has stepped up its efforts in New Jersey with its Diabetes Chronic Care Program, a holistic approach to help its members control their diabetes. Beyond providing coverage for primary care and specialty services for Horizon members with diabetes need to maintain their health, Horizon offers access to registered dieticians, social workers, behavioral health professionals and pharmacists to help manage the many ways diabetes can impact an individual’s life.

Through the Chronic Care Program, Horizon provides reminders for important monitoring tests, including dilated eye exams, foot examinations, A1C, LDL and microalbuminuria testing. Members also receive education and support from a nurse care manager who can help with navigating the health care system and coordinating care.

At the beginning of 2019, 38,000 members with diabetes were enrolled in Horizon’s Chronic Care Program. Diabetes is often just one of multiple conditions that this program handles. That’s because the same person with diabetes may also be suffering from congestive heart failure, hypertension or stroke. The Chronic Care Program is available to eligible members at no charge.

By coordinating care and engaging members before their health conditions worsen, the Chronic Care Program also works to help lower health care costs.

This is especially important because diabetes places a sizable economic burden on the state. It’s estimated that diabetes costs New Jersey about $14.5 billion each year, rising to almost $18 billion by 2030.

In addition to promoting more effective care which may help avoid complications and lead to lower claims costs through the Chronic Care Program, Horizon also helps make diabetes care more affordable by giving providers the tools to reduce pharmaceutical expenses.

Today, treating diabetes involves managing an ever-growing list of antidiabetic medications. To assist doctors in selecting the most cost-effective drugs for their patients, Horizon provides an innovative software solution: Drug-Cost Decision Support at Prescribing (DDP) from Gemini Health. It delivers up-to-date medication and alternative cost information to doctors via patients’ electronic health records, helping patients manage out-of-pocket costs.

Preventing diabetes one community at a time

More than one out of three adults nationwide has prediabetes. Preventing this from becoming Type 2 diabetes is critical to keeping New Jersey as healthy as possible.

It can take more than changing individual lifestyle habits to prevent diabetes; it also takes a broad, community-based approach. That’s because many people struggle with the disease due to social determinants of care, including poverty, lack of understanding of good nutrition, living in a “food desert” (where it is difficult to find affordable or good-quality fresh food), transportation and limited access to medical care.

To make the biggest impact at the community level, Horizon has focused on certain areas in New Jersey that have a higher prevalence of diabetes. To help these predominantly urban areas, Horizon’s philanthropic arm - the Horizon Foundation for New Jersey - has focused on diabetes education, issuing 116 grants for diabetes-related initiatives.

For example, the Foundation has partnered with the New Jersey YMCA State Alliance over the past 10 years to support Healthy U, a program aimed at preventing childhood obesity through improved nutrition, increased physical activity and parental involvement. Today, the program is implemented in all 21 counties throughout New Jersey, reaching more than 40,000 children ages 3-13.

In addition, the Foundation has supported community clinics, such as the Parker Family Health Center’s (PFHC) diabetes program, which works to prevent the disease through education, awareness, screenings and referrals for high-risk individuals in Monmouth County. The Foundation has also invested in the Bergen Volunteer Medical Initiative, Bergen County’s only health care center to provide free primary care to low-income residents who are working but don’t have insurance.

We have more investments to make – and more work to be done – to get the diabetes epidemic under control in New Jersey. But Horizon BCBSNJ is committed to collaborating with non-profit organizations, health care providers and our members across the state to put us all on a healthier path forward.