TAMPA, FL – iCare Health Solutions, LLC (iCare) has announced that its Diabetic Retinal Exam (DRE) patient outreach program has helped five of its Florida-based Medicare Advantage partners earn the CMS Five-Star rating for their Healthcare Effectiveness Data and Information Set (HEDIS) Diabetic Retinal Exam (DRE) measure. “Achieving five stars for the DRE measurement is difficult,” says Tamara Bruns, Executive Vice President of Care Delivery Transformation at iCare. “It requires a strategic approach and ongoing effort to overcome geographical, socioeconomic, and communication challenges to reach our targeted populations. For five health plans to achieve the five-star rating is rare. Our team did an outstanding job. We are incredibly proud of this accomplishment.”
iCare works with its contracted HEDIS health plan partners by targeting members who are non-compliant for their diabetic retinal exam. “When engaging non-compliant members, it’s important to understand the reasons why members might skip or avoid a dilated eye exam or screening,” states Bruns. “These reasons can include, but are not limited to, the inability to drive or lack of access to transportation, little or no education regarding the potential impacts of vision loss or blindness associated with diabetes, or the unwillingness to have their eyes dilated. iCare’s outreach program offers members options to help overcome these barriers. We offer dilated exams through our ocular health network of providers or non-dilated screenings conducted by iCare technicians at the member’s primary care physician’s office, clinics, health fairs, health plan partner events, or the member’s residence. Providing non-compliant health plan members with choices that met their needs is fundamental to the success of the program.”
According to The Centers for Disease Control and Prevention (CDC) National Diabetes Statistics Report, 2017, diabetes affects more than 30 million Americans. The CDC report also states almost one-third of adults over 40 years are affected by diabetic retinopathy – an eye disease that is one of the most common causes of vision loss and blindness.
“Diabetic retinopathy progressively damages the retina, which is why early detection and treatment can prevent vision loss,” adds Bruns. ”For this reason, DREs are an essential part of diabetic care. Our DRE patient outreach program is one of the most impactful ways we can improve health outcomes for our health plan partners’ members.”
iCare’s contracted HEDIS health plan partners benefiting from iCare’s customized outreach DRE solutions include CarePlus, Coventry, Humana, United Healthcare’s Medica Healthcare, and Preferred Care Partners programs, and others.
HEDIS is a tool used by more than 90 percent of America’s health plans to measure performance based on critical dimensions of care and service, including how many of their members receive preventive health screenings. Health plans offering Medicare and Medicaid services must identify members who are out of compliance and encourage them to undergo testing, follow up, and treatment.
iCare Health Solutions is a managed ocular health organization founded by Sidney J. Stern, OD. iCare contracts with health plans and multi-specialty clinics and delivers comprehensive ocular solutions through its network of optometrists and ophthalmologists. For more than 30 years, the company has met the challenges of the ever-changing health care landscape to transform the way ocular health is delivered to help more people see better, feel better, and live healthier lives.