Consider tailored approaches for health management
If your health management program is seeing an increase in members with diabetes, you’re not alone.
A study by the Health Care Cost Institute (HCCI) released in December 2013 found that the prevalence of diagnosed diabetes is rising across the country.
In 2012, 8.8% of individuals younger than 65 who had employer-sponsored health insurance had diagnosed diabetes, gestational diabetes or pre-diabetes. In 2008, the prevalence of diagnosed diabetes was 6.4%.
Even more alarming is the rate of diagnosed diabetes in specific subpopulations, says study co-author and HCCI Senior Researcher Amanda Frost, PhD. Only 0.6% of children covered by employer-supplied insurance had diabetes in 2012, but 11.6% of adults age 19 to 64 had diabetes. Greater than 10% of the overall study population in the Mid-Atlantic, South Atlantic and East South Central states had diabetes in 2012.
Women with diabetes outnumber men until age 44, but men with diabetes outnumber women in older cohorts. Overall, 76.6% of individuals with diabetes in the study were ages 45 through 64.
“The subpopulations are not getting enough attention,” Frost says. “Most people focus on the overall population numbers.”
HCCI analyzed claims data weighted to be representative of the employer-sponsored insured population nationwide for 2007 to 2012. Claims data were based on ICD-9 codes as suggested by the Dictionary of Disease Management Terminology. Claims data showed that while the absolute number of individuals covered by employer-supplied insurance fell during the study period, the prevalence of diabetes within the insured population increased.
Researchers found an increase in the prevalence of diabetes in each year of the study within the overall population, as well as within each subgroup except children aged four and younger.
The greatest change in prevalence was in adults older than 25. In 2008, about 4.1% of adults aged 26 to 44 had diabetes compared to 6.1% in 2012. Over the same period, the percentage of adults aged 45 to 54 with diabetes increased from 10.1% to 14.3%. The oldest cohort, adults aged 55 to 64, showed the greatest increase in diabetes, jumping from 18.5% in 2008 to 24% in 2012. For all adults, the prevalence rates rose from 8.4% to 11.6% while the rate among children rose from 0.4% to 0.6%.
Diabetes in the insured population also varies geographically. States in the West showed the lowest rates of diabetes throughout the study period, while states in the South showed the highest prevalence.
According to co-author Carolina Herrera, MA, HCCI Director of Research, “There are clear implications in terms of population management of diabetes based on sex, age and geography.”
Read key findings from HCCI.