Medicaid expands diabetes care


The state health department has beefed up its Medicaid benefits for diabetics -- offering a larger array of services in hopes of preventing the serious complications that make patients ill and cost taxpayers millions.

The Diabetes Care Program, in its first week of operation, offers the new services to patients who agree to obtain all their medical services through a primary care doctor certified by the state as an expert in the care of diabetes.

In diabetes, the pancreas produces little or no insulin, the hormone that makes it possible for cells to absorb and use glucose for their energy needs. The disorder produces symptoms including heart and kidney disease and circulatory problems that often lead to foot amputations.

New benefits include home glucose monitors, prescription footwear, diabetes education and nutrition counseling. Doctors are expected to help patients follow a correct diet and pay close attention to glucose levels -- lesseningthe chance of serious complications.

Officials with the state Department of Health and Mental Hygiene estimate that the enhanced services will cost $1.7 million during the first year. But they project a net savings of $2.4 million -- largely through reduced hospitalizations.

There are an estimated 20,000 diabetics on the Medicaid rolls. People eligible for the new program are the estimated 2,000 who have been hospitalized at least once for complications of diabetes.

The program, unveiled yesterday by Health Secretary Nelson J. Sabatini, stems from studies showing that diabetics incur disproportionately high costs that can be trimmed if patients get regular treatment aimed at preventing complications.

In 1987, the Maryland Medical Assistance Program -- or Medicaid -- paid nearly $40 million in claims for services to diabetics, of which $32 million was for hospital care. The Department of Health and Mental Hygiene has enrolled about 110 physicians as providers, and officials say they hope to enroll more.

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