Partnering with Insurers in Caring for the Most Vulnerable Youth with Diabetes: NICH as an Integrator.
In this review, we outline barriers to appropriately caring for high-risk youth with diabetes and discuss efforts in partnering with insurers through Alternative Payment Models to achieve the Triple Aim (improved health, improved care, and reduced costs) for this population.



Current approaches in caring for youth with diabetes who evidence a high degree of social complexity are woefully ineffective. These youth are vulnerable to repeat diabetic ketoacidosis episodes, poor glycemic control, and excessive utilization of healthcare resources. To effectively pursue the Triple Aim, an "integrator" (i.e., an entity that accepts responsibility for all components of the Triple Aim for a specified population) must be identified; however, this does not fit into current fee-for-service models. Integrators for youth with diabetes are limited, but early examples of integrator efforts are promising. We present one successful "integrator," Novel Interventions in Children's Healthcare (NICH), and detail this program's efforts in partnering with insurers to serve high-risk youth with diabetes.
University of Massachusetts Medical Center, Diabetes Center of Excellence, UMass Medical School, 368 Plantation St., Worcester, MA, 01605, USA.
Samantha A
SA
Barry
Oregon Health & Science University OHSU, 707 SW Gaines Street, Portland, OR, 97239, USA.
Lena
L
Teplitsky
Oregon Health & Science University OHSU, 707 SW Gaines Street, Portland, OR, 97239, USA.
David V
DV
Wagner
CareOregon, 315 SW 5th Ave, Portland, OR, 97204, USA.
Amit
A
Shah
Oregon Health & Science University OHSU, 707 SW Gaines Street, Portland, OR, 97239, USA.
Brian T
BT
Rogers
Oregon Health & Science University OHSU, 707 SW Gaines Street, Portland, OR, 97239, USA. harrismi@ohsu.edu.|Harold Schnitzer Diabetes Health Center, Portland, OR, 97239, USA. harrismi@ohsu.edu.
Michael A
MA
Harris
D000293:Adolescent; D002648:Child; D002662:Child Health Services / Q000458:organization & administration*; D003920:Diabetes Mellitus / Q000628:therapy*; D004645:Empathy; D018588:Fee-for-Service Plans; D006801:Humans; D007343:Insurance Carriers
APM; NICH; Type 1 diabetes