Diabetes Care

Approximately 40,000 South Dakotans have diabetes (diagnosed and undiagnosed). Because of the prevalence of and necessity for daily management of diabetes, a large number of claims are made for care of this condition. Through Diabetes Care, Disease Management teams members with medical staff who provide individualized, preventive care to keep them healthier and reduce claims costs.

How the Diabetes Program Works:

Pharmacy and claims data is monitored to identify members at a higher health risk for diabetes. Then, these members are contacted and receive the following individualized care management from a DAKOTACARE Registered Nurse: 

• Individuals are contacted about program participation. Program materials are then sent to an individual’s primary care physician, and the individual receives an information packet that explains the program and includes educational materials.
• Program participants are risk-stratified, and our staff performs more intensive interventions with those identified as high-risk. Members are teamed with their physician, clinic and local area staff who provide:

o   Documentation and tracking of medical care, including appointment reminders and referral assistance for support services;

o   Assessment of member progress in self-management programs and reinforcement of any educational and compliance deficits through follow-up contacts;

o   Continuous communication to assess and enhance current progress and compliance;

o   Toll-free phone service for clinical and behavioral support as needed.

• Central data collection system maintenance for each member’s private information that serves as their overall plan resource.